Correlation Between Serum Cystatin C Concentration And Corornary Lesions In Patients With Coronary Heart Disease And Normal Kidney Function

ObjectivesTo analyze the correlation between serum cystatin C concentration and corornary lesions in patients with coronary heart disease and normal kidney function, and assess the predictive value of serum cystatin C concentration on the severity of coronary arterial lesions.Methodswe prospectively enrolled 418 consecutive inpatients with normal renal function admited to the cardiovascular medcine of our hospital from January 2011 to March 2012.They all had chest pain or chest tightness,and/or their electrocardiogram indicated myocardial ischemia and the result of exercise treadmill testing was positive.All of the patients were administered coronary angiography. Blood samples were obtained within24 h of admission.The serum cystatin C concentration and the biochemical parameters were measured by automatic biochemical analyzer. According to the results of coronary angiography, 316 patients were diagnosed as coronary heart disease(CHD group),,whereas 102 patients were non-CHD(control group). According to the number of coronary vessels with lesions,the patients in CHD group were divided into the following groups:single coronary lesion group,double coronary lesions group and multiple coronary lesions group.The patients with CHD were also divided into two groups: the mild coronary arterial stenosis group and the severe coronary arterial stenosis group,according to the severity of coronary arterial stenosis.Gensini scores were calculated for all of the patients.The correlation between serum Cystatin C concentration and corornary lesions in patients with CHD was discussed from the following aspects:the number of coronary vessels with lesions,the severity of coronary arterial stenosis and the CHD Gensini scores.Results1 、 Comparison of the clinical parameters between the CHD group and the control group:The percentage of male patients was higher in the CHD group. The percentage of the elder patients and patients with a history of drinking, smoking, hypertension in the CHD group were significantly higher than those in the control group(p<0.05).Compared to the control group, creatinine、blood urea nitrogen and uric acid in the CHD group were significantly higher(p<0.05),whereas High density lipoprotein cholesterol was significantly lower(p<0.05). The concentrations of Low density lipoprotein cholesterol、fasting blood glucose、triglycerides and total cholesterol in two groups had no difference(p>0.05).The concentrations of cystatin C in two groups were normal distribution, whereas Gensini scores did not conform to normal distribution.2 、 The concentration of cystatin C and Gensini scores in the CHD group were significantly higher than those in the control group(1.24±0.32 vs. 1.12±0.27, p <0.01;0.00±3.00 vs. 16.00±33.00,p <0.001). Cystatin C was positively correlated with the Gensini scores of coronary arterial lesions(r=0.195, p <0.01).3 、Compared to the control group,the concentrations of cystatin C in patients with double coronary lesions group and multiple coronary lesions group were significantly higher(1.24±0.32 vs. 1.12±0.27;1.31±0.31 vs. 1.12±0.27,p <0.01).Moreover, the concentration of cystatin C in patients with multiple coronary lesions group were significantly higher than that in patients with single coronary lesion group(1.31±0.31 vs.1.20±0.32, p <0.01).The difference of the concentrations of cystatin C between the double coronary lesions group and multiple coronary lesions group was no statistical significance,and the result between the single coronary lesion group and the control group was also the same.4、The concentration of cystatin C in the severe coronary arterial stenosis group was significantly higher than that in the mild stenosis group(1.29±0.36 vs.1.16±0.23,p<0.01).5、The patients were divided into quartile based on admission cystatin C concentrations in CHD group. The number and the degree of stenosed coronary vessels in four groups were statistical significance(p < 0.05). The patients with multi-vessel lesions and severe stenosis in the group with the highest cystatin C concentration was significantly higher than that in the group with the lowest cystatin C concentration(p <0.05).Conclusion1、Serum cystatin C concentration increased in patients with CHD and normal renal function.It were positively associated with the degree of coronary arterial lesions.Serum cystatin C concentration has certain predictive value on coronary arterial lesions in patients with CHD.2、Serum cystatin C concentration increased significantly in patients with coronary vascular stenosis reached or exceeded 75%. For the clinical doctors,serum cystatin C concentration could be a preliminary screening index, has a certain value on the assessment to coronary revascularization of patients with CHD and normal renal function.