Diagnostic Value Of Serum Cystatin C In Patients With Acute Myocardial Infarction And Heart Failure

Objective: To observe the correlation between serum cystatin C(Cys C) and n-terminal pro-b-type natriuretic peptide(NT-pro BNP levels) in patients with acute myocardial infarction and heart failure, and to to investigate the diagnostic value of serum cystatin C in acute myocardial infarction complicated with acute left heart failure value.Methods: In this study, 183 patients with acute myocardial infarction in our hospital from January 2012 to January 2015 were selected to study. General information of patients were recorded. Venous blood was taken from patients to detect serum NT-pro BNP levels by electrochemical luminescence method and serum Cys C levels by immune turbidity method.The Killips grade ?-IV was as the diagnostic criteria of acute left heart failure standard. According to whether the occurrence of acute left heart failure patients were divided into non heart failure group(A group, n=98 cases)and heart failure group(B group, n=85 cases).The correlation between NT-pro BNP and Cys C was compared. The sensitivity, specificity, Jorden index, optimal truncation value(cut-off) and area under the curve(AUC) of prediction of acute myocardial infarction complicated by acute myocardial infarction with NT-pro BNP and Cys C were observed and compared.Results: The Cys C levels of A, B groups were(0.89 + 0.42) mg/L and(1.97 + 0.65)mg/L,respectively, and the difference was statistically significant(p< 0.01). The NT-pro BNP levels of A, B groups were(1315.24 + 1410.37) pg / ml and(4637.19 +2444.30) pg / ml, respectively, and the difference was statistically significant(p<0.01). Person correlation shows that there is a positive correlation of C NT-pro BNP and Cys(r=0.616, p < 0.001). The sensitivity, specificity, Jorden index, Cut-off value,AUC and 95%CI of Cys C in predicting acute left heart failure were 86.44%, 81.94%,0.7838, 1.357, 0.955 and 0.914-0.980, respectively, while the sensitivity, specificity,Jorden index, Cut-off value, AUC and 95%CI of NT-pro BNP in predicting acute left heart failure were 86.44%, 69.35%, 0.5580, 1286.0, 0.821 and 0.758-0.874,respectively.The specificity and AUC of Cys C were higher than that of NT-pro BNP.Z test showed that AUC of Cys C is higher than that of NT-pro BNP(Z=4.678, P <0.001).Conclusion: The level of serum Cys C in patients with acute myocardial infarction is positively correlated with the level of NT-pro BNP. Cys C and NT-pro BNP in predicting acute left heart failure have a higher predictive value, and it is worth to be spread.