Cystatin C as an index of acute cerebral infraction recurrence: one-year follow-up study

Background and purpose: Cystatin C is associated with acute cerebral infarction (ACI). However, the correlation of serum cystatin C level with recurrence of ACI and different subtypes of ACI had not been fully clarified. The aim of this study was to detect the relationship between serum cystatin C level and recurrent ACI in one-year follow-up and different subtypes of ACI. Methods: A total of 532 consecutive patients with ACI and 339 healthy controls were included. All ACI patients were followed up for one year, the clinical and biochemical characteristics of ACI and ACI recurrent patients were documented and analyzed. Results: A total of 477 (89.7%) patients completed one-year follow-up study, 64 (13.4%) patients suffered ACI recurrence. The results showed serum cystatin C was 1.04 +/- 0.19 mg/L and 1.14 +/- 0.49 mg/L in control and ACI, respectively (p< .001). The significant risk factors for ACI recurrence were presence of hypertension (p = .009, OR =3.32), diabetes (p =.03, OR =1.87), coronary heart disease (p = .01, OR =2.46), and cystatin C (p = .003, OR =2.87). The risk of ACI recurrence increased with serum cystatin C level. Additionally, cystatin C level was associated with different subtypes of ACI; large-artery atherosclerosis (LAA) subtype had the highest level of cystatin C in ACI and recurrent ACI group. Conclusions: Serum cystatin C level is an independent prediction biomarker for ACI recurrence. LAA subtype of ACI and ACI recurrence was more closely related to elevated cystatin C level.