Marta Negrusz-Kawecka1, Rafał Poręba2, Anna Hulok1, Krzysztof Sciborski1, Jakub Marczak3, Tomasz Bańkowski4. 1. Department and Clinic of Cardiology, Wroclaw Medical University, Poland. 2. Department and Clinic of Internal Medicine, Occupational Diseases and Hypertension, Wroclaw Medical University, Poland. 3. Department and Clinic of Cardiac Surgery, Wroclaw Medical University, Poland. 4. Department of Cardiac Surgery, Medinet Heart Center Ltd., Nowa Sól, Poland.
Abstract
OBJECTIVES: Cystatin C is a novel marker used in the diagnosis of preclinical chronic kidney disease (CKD). The aim of the study was to assess the role of cystatin C in the diagnosis of coronary artery disease. MATERIAL AND METHODS: The study involved 63 patients of a mean age of 62.7 ± 9.5 years. The population was divided into two groups: Group I were patients with angiographically diagnosed coronary artery disease (CAD) with their first acute coronary syndrome (ACS, n = 45); Group II were patients who had clinically diagnosed coronary disease but were negative on angiography (n = 18). Cystatin C levels were measured before angiography in both groups; in Group I they were also measured 6 months after discharge. RESULTS: Cystatin C levels were significantly higher in Group I (p = 0.01), and this depended on the type of CAD: non-ACS, non-ST elevated myocardial infarction (NSTEMI) or ST elevated myocardial infarction (STEMI) (p = 0.01). Cystatin C levels correlated inversely with the left ventricular ejection fraction in the whole study population (p = 0.003) and in patients with NSTEMI (p = 0.03). A high cystatin C level was found to be a risk factor for ACS (OR: 1.002 95% CI [1.00029-1.004], p = 0.02) and STEMI (OR: 1.0009 95% CI [0.99-1.002], p = 0.04) but not for NSTEMI (OR: 0.99 95% CI [0.99-1.0], p = 0.21. A ROC analysis revealed that there is a significantly higher risk of ACS above a cystatin C level of 727.85 ng/mL (OR: 5.5 CI [1.65-18.3], p = 0.004) and a significantly higher risk of STEMI above 915.22 ng/mL (OR: 5.9 CI [1.7-19.7], p = 0.003). CONCLUSIONS: The available data suggest that a high cystatin C level is a risk factor for ACS and STEMI. This could play an important role in the early diagnosis and prevention of adverse cardiovascular events.
OBJECTIVES:Cystatin C is a novel marker used in the diagnosis of preclinical chronic kidney disease (CKD). The aim of the study was to assess the role of cystatin C in the diagnosis of coronary artery disease. MATERIAL AND METHODS: The study involved 63 patients of a mean age of 62.7 ± 9.5 years. The population was divided into two groups: Group I were patients with angiographically diagnosed coronary artery disease (CAD) with their first acute coronary syndrome (ACS, n = 45); Group II were patients who had clinically diagnosed coronary disease but were negative on angiography (n = 18). Cystatin C levels were measured before angiography in both groups; in Group I they were also measured 6 months after discharge. RESULTS:Cystatin C levels were significantly higher in Group I (p = 0.01), and this depended on the type of CAD: non-ACS, non-ST elevated myocardial infarction (NSTEMI) or ST elevated myocardial infarction (STEMI) (p = 0.01). Cystatin C levels correlated inversely with the left ventricular ejection fraction in the whole study population (p = 0.003) and in patients with NSTEMI (p = 0.03). A high cystatin C level was found to be a risk factor for ACS (OR: 1.002 95% CI [1.00029-1.004], p = 0.02) and STEMI (OR: 1.0009 95% CI [0.99-1.002], p = 0.04) but not for NSTEMI (OR: 0.99 95% CI [0.99-1.0], p = 0.21. A ROC analysis revealed that there is a significantly higher risk of ACS above a cystatin C level of 727.85 ng/mL (OR: 5.5 CI [1.65-18.3], p = 0.004) and a significantly higher risk of STEMI above 915.22 ng/mL (OR: 5.9 CI [1.7-19.7], p = 0.003). CONCLUSIONS: The available data suggest that a high cystatin C level is a risk factor for ACS and STEMI. This could play an important role in the early diagnosis and prevention of adverse cardiovascular events.
Authors: Anandita Agarwala; Salim Virani; David Couper; Lloyd Chambless; Eric Boerwinkle; Brad C Astor; Ron C Hoogeveen; Joe Coresh; A Richey Sharrett; Aaron R Folsom; Tom Mosley; Christie M Ballantyne; Vijay Nambi Journal: Atherosclerosis Date: 2016-08-25 Impact factor: 5.162