{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T05:03:37Z","timestamp":1785301417380,"version":"3.55.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"\n Background<\/jats:title>\n Serum cystatin C (Cys-C) has been established as a prognostic marker in various cardiovascular settings, but its changes and their relationship with long-term outcomes in ST-segment elevation myocardial infarction (STEMI) patients remain underexplored. Therefore, this study aims to evaluate the prognostic value of serum Cys-C concentration and its changes in predicting all-cause mortality in STEMI patients with normal or mildly impaired renal function.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This single-center, retrospective observational study enrolled 753 STEMI patients who underwent emergency percutaneous coronary intervention between February 2019 and December 2024. Serum Cys-C levels were measured at baseline and the last measurement. Patients were categorized into tertiles based on baseline Cys-C, follow-up Cys-C, and the absolute change in Cys-C. The primary endpoint was all-cause mortality.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n During follow-up of 627 days, 75 deaths occurred. Non-survivors had significantly higher baseline and follow-up Cys-C levels, as well as greater absolute increases in Cys-C, compared to survivors (all\n p<\/jats:italic>\n \u2009&lt;\u20090.001). Kaplan\u2013Meier analysis showed significantly worse survival in the highest tertiles of baseline Cys-C (log-rank\n p<\/jats:italic>\n \u2009&lt;\u20090.001), follow-up Cys-C (\n p<\/jats:italic>\n \u2009&lt;\u20090.0001), and Cys-C change (\n p<\/jats:italic>\n \u2009=\u20090.009). After multivariable adjustment, the highest tertile of baseline Cys-C was associated with a 2.20-fold increased risk of mortality (95% CI: 1.19\u20133.88,\n p<\/jats:italic>\n \u2009=\u20090.012). The highest tertile of follow-up Cys-C was associated with a 3.12-fold increased risk of mortality (95% CI: 1.79\u20135.99,\n p<\/jats:italic>\n \u2009&lt;\u20090.001), while the highest tertile of Cys-C change conferred a 2.10-fold increased risk (95% CI: 1.14\u20133.68,\n p<\/jats:italic>\n \u2009=\u20090.017).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Elevated serum Cys-C levels at baseline and the last measurement, as well as an increase in Cys-C over time, are independently associated with higher all-cause mortality in STEMI patients. Serial measurement of Cys-C may enhance risk stratification and serve as a dynamic indicator for monitoring disease progression and treatment response.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1816496","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T04:46:02Z","timestamp":1785300362000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic value of serum cystatin C and its changes in patients with ST-segment elevation myocardial infarction"],"prefix":"10.3389","volume":"13","author":[{"given":"Nannan","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Emergency, Changhai Hospital, The First Affiliated Hospital of Naval Medical University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guandong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Emergency, Changhai Hospital, The First Affiliated Hospital of Naval Medical University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjie","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Emergency, Changhai Hospital, The First Affiliated Hospital of Naval Medical University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Emergency, Changhai Hospital, The First Affiliated Hospital of Naval Medical University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2361","DOI":"10.1016\/j.jacc.2022.11.005","article-title":"The global burden of cardiovascular diseases and risk: a compass for future 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