The Levels Of Cystatin C And Homocysteine And Its Clinical Values In Patients With Coronary Heart Disease

Objective:This study was designed to observe the change of the serum cystatin C(CysC) and homocysteine(HCY) levels in patients with different type of coronary heart disease and explore the forecast value of cystatin C and homocysteine on coronary artery stenosis severity. Analysis its correlation with the GRACE(Global Registry of Acute Coronary Events) risk score among the non ST-segment elevation acute coronary syndrome (NSTE-ACS) patients.Methods:160cases of inpatients after coronary angiography(CAG) examination was chose and divided into two groups:124patients with coronary heart disease(CHD)-in which there are35patients of single diseased coronary vessel,38patients of double diseased coronary vessels and51of many diseased coronary vessels-and36without coronary heart disease(as the control group). CHD angiographic severity was evaluated with a Gensini scoring system. All the subjects’ related clinical data were collected. The concentration of CysC and HCY were measured by appropriate method. All the selected were definite known diseased coronary vessels by CAG and coronary Gensini score. And the GRACE risk score was calculated among the NSTE-ACS patients. Then the patients with CHD were divided into severe stenosis (>90points), moderate stenosis (30-90points) and mild stenosis (<30points) according to the coronary Gensini score. Patients with NSTE-ACS were divided into high-risk group (>118points), moderate-risk group (89-118points) and low-risk group (<89points) according to the GRACE risk score. Compare cystatin C and homocysteine among every group and its relationship with diseased coronary vessel. Results:(1)The concentration of serum CysC and HCY in patients with CHD was significantly higher than the non-coronary heart disease patients (P<0.01).(2) The CysC and HCY concentration of double diseased coronary vessels are higher than single diseased (P<0.01), and which in many diseased coronary vessels group is higher than the former (P<0.01).(3)There is a obviously positive correlation between CysC and HCY level and coronary Gensini score (r=0.573and0.645,P<0.01). The CysC and HCY concentration of moderate stenosis group are all higher than mild stenosis(P<0.01), and which in severe stenosis group is higher than the former (P<0.01).(4) There is a obviously positive correlation between CysC and HCY level and the GRACE risk score (r=0.662and0.582,P<0.01). The CysC and HCY concentration of high-risk group are all higher than moderate-risk group and low-risk group (P<0.01), and which in moderate-risk group and low-risk group is higher than the control group (P<0.01).Conclusions:(1)Serum CysC and HCY were significantly increased in patients with coronary heart disease, and were positively correlated with coronary gensini score. Combined determination of serum cystatin C and homocysteine may provide new ideas for forecasting the coronary artery stenosis degree.(2)Serum CysC and HCY were significantly increased in patients with NSTE-ACS, and were positively correlated with the GRACE risk score.