Predictive Value Of Cystatin C To Left Ventricular Ejection Fraction Ratio In The Long-term Outcomes Of Patients With Coronary Heart Disease Who Undergoing PCI

Objective: The purpose of this study was to determine whether cystatin C/left ventricular ejection fraction(LVEF)ratio(CLR)on admission is predictive of long-term outcome in patients with coronary heart disease.Methods: The clinical data included cystatin C,left ventricular ejection fraction and others correlation index of 14733 patients after PCI.Data on patients admitted to the First Affiliated Hospital of Xinjiang Medical University from December 2016 through October 2021 were collected.All cause mortality(ACM),cardiac mortality(CM),major adverse cardiovascular events(MACEs),major adverse cardiac and cerebrovascular events(MACCEs)and non-fatal myocardial infarction(NFMI)was set as follow-up endpoint events.Receiver operating characteristic(ROC)curve analysis were used to determine the optimal CLR ratio 0.019 for grouping.The patients divided into two groups,high CLR group(CLR≥0.019)and low CLR group(CLR＜0.019).Multi-factor Cox regression analysis was used to compare the correlation between different groups and long-term prognosis.Results: The high CLR group had higher ACM(8.8% vs 0.9%),CM(6.7% vs 0.6%),MACEs(12.7% vs 5.9%),MACCEs(13.3% vs 6.7%),NFMI(3.3% vs 0.9%).An analysis of multivariate Cox regression showed that the risk of all-cause death in the high CLR group was 7.163 times higher than that in the low CLR group(HR=8.163,95%CI: 4.730～14.087,P＜0.001)as compared with the low CLR group,cardiac death was 9.643 times higher than that in the low CLR group(HR=10.643,95%CI: 5.525～20.501,P＜0.001),non-fatal myocardial infarction was 0.580 times higher than that in the low CLR group(HR=1.580,95%CI: 1.273～1.960,P＜0.001),the incidence of MACEs was 1.352 times higher than that in the low CLR group(HR=2.352,95%CI: 1.754～3.154,P＜0.001),the incidence of MACCEs was 1.137 times higher than that in the low CLR group(HR=2.137,95%CI: 1.611～2.834,P＜0.001).Conclusion: High CLR is associated with poor prognosis after PCI which can be an independent risk factor for ACM,CM,NFMI,MACEs and MACCEs.