Is low cystatin C in acute stroke a blessing or a curse? a pilot study on Egyptian patients

Introduction: Cerebrovascular stroke is a costly disease. Elevated cystatin C levels were independently associated with both ischemic and hemorrhagic stroke. In contrast, cystatin C has been found to play protective roles in the nervous system. Aim: The aim of the present study was to find out the relationship between serum cystatin C level and the outcome of acute cerebrovascular stroke in middle aged and elderly Egyptian patients. Patients and methods: This study was conducted on 49 patients with recent stroke and normal kidney functions and 30 healthy matched controls. All patients were followed up for 1 week. Cystatin C was determined for both patients and controls. Results: Cystatin C level tended to be lower in patients than in controls, both below and above the age of 60. Females tended to have higher levels of cystatin C. There was a gradual decrease in the cystatin C level according to the outcome, being least in the deteriorated group. However, the differences were insignificant. Conclusion: The results suggest that low cystatin C level - in a patient with normal kidney function - may predict worse prognosis. Accordingly, creatinine estimation is mandatory in assessing the kidney function in these patients and cystatin cannot replace it, as it may represent another risk factor.