Cystatin C
CST3proteinCystatin C reflects glomerular filtration and renal function; elevated levels indicate cardiorenal risk and mortality in acute coronary syndrome.
Pathway placement
Cascade stepOff-pathway / systemic markers
Confidencehigh
RationaleRenal function and cardiorenal stress marker; prognostic indicator independent of atherothrombotic cascade.
Druggability
DruggableYes
Known drugs / candidates0
Small-molecule tractableYes
Antibody tractableYes
EnsemblENSG00000101439
Type I vs Type II discrimination
ScoresShared / rises in both
R — rupture / Type-I67
C — confounder / Type-II67
A — assay feasibility68
E — evidence strength62
T1DI (composite)16
Specificity differential (R−C)-24
Direct evidence: higher in Type II (D=-2)
T1MI: 1.07 mg/L vs T2MI: 1.24 mg/L (p<0.05 after adjustment)
Confounder panel (Type-II drivers)
1sepsis / systemic inflammationmag 2
2anemia / acute blood lossn/a
3hypovolemia / dehydrationmag 2
4tachyarrhythmian/a
5hypoxemia / respiratory failuremag 2
6hypertensive emergencyn/a
7high-demand / peri-operative stressmag 2
Coverage: 4/7 confounders with evidence
Tier: deep-scored (abstract-extracted) · 11 supporting references. See the discrimination table for all markers.
Assay & specimen
Validated clinical assay
Specimen
Serum or plasma
Collection tube
Serum separator (gold/red-top, SST) · Lithium heparin (green-top)
Method / principle
Immunoturbidimetric/nephelometric
Reagent / substrate
Anti-cystatin C antibody-latex
Platform
Automated analyzer
Turnaround · availability
Routine · Widely available
Human genetic evidence
0.016
Open Targets association (STEMI)
Literature evidence(17)
- Cystatin C in atherosclerotic cardiovascular disease.Clinica chimica acta; international journal of clinical chemistry · 2025 · PMID 41237923 · doi
- Biomarkers and cardiovascular events in patients with stable coronary disease in the ISCHEMIA Trials.American heart journal · 2023 · PMID 37604357 · doi
- A multiplexed immunochemical microarray for the determination of cardiovascular disease biomarkers.Mikrochimica acta · 2023 · PMID 38151630 · doi
- Comprehensive assessment of systemic arteriosclerosis in relation to the ocular resistive index in acute coronary syndrome patients.Scientific reports · 2022 · PMID 35149710 · doi
- Preoperative biomarker evaluation for the prediction of cardiovascular events after major vascular surgery.Journal of vascular surgery · 2019 · PMID 31653377 · doi
- Fibrin clot properties independently predict adverse clinical outcome following acute coronary syndrome: a PLATO substudy.European heart journal · 2018 · PMID 29390064 · doi
- Cystatin C for Risk Stratification in Patients After an Acute Coronary Syndrome.Journal of the American Heart Association · 2018 · PMID 30371283 · doi
- C-terminal fragment of agrin (CAF) levels predict acute kidney injury after acute myocardial infarction.BMC nephrology · 2017 · PMID 28646861 · doi
- Plasma cystatin C and neutrophil gelatinase-associated lipocalin in relation to coronary atherosclerosis on intravascular ultrasound and cardiovascular outcome: Impact of kidney function (ATHEROREMO-IVUS study).Atherosclerosis · 2016 · PMID 27680774 · doi
- Relation of baseline plasma MMP-1 levels to long-term all-cause mortality in patients with known or suspected coronary artery disease referred for coronary angiography.Atherosclerosis · 2015 · PMID 25635325 · doi
- Prognostic impact of established and novel renal function biomarkers in myocardial infarction with cardiogenic shock: A biomarker substudy of the IABP-SHOCK II-trial.International journal of cardiology · 2015 · PMID 25965624 · doi
- Biomarkers in stable coronary heart disease, their modulation and cardiovascular risk: The LIPID biomarker study.International journal of cardiology · 2015 · PMID 26318511 · doi
- Analysis of biomarkers for risk of acute kidney injury after primary angioplasty for acute ST-segment elevation myocardial infarction: results of the HORIZONS-AMI trial.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2014 · PMID 25130788 · doi
- Serum extracellular vesicle protein levels are associated with acute coronary syndrome.European heart journal. Acute cardiovascular care · 2013 · PMID 24062934 · doi
- Cystatin C as a predictor of all-cause mortality and myocardial infarction in patients with non-ST-elevation acute coronary syndrome.Clinical biochemistry · 2012 · PMID 22394460 · doi
- [Inflammation, atherosclerosis and cardiovascular disease risk: PAPP-A, Lp-PLA2 and cystatin C. New insights or redundant information?].Revista espanola de cardiologia · 2006 · PMID 16712749
- Cystatin C: a novel predictor of outcome in suspected or confirmed non-ST-elevation acute coronary syndrome.Circulation · 2004 · PMID 15477399 · doi