Serum Cystatin C Level In Patients With Coronary Heart Disease

Background and Objective: Cystatin C is an ideal marker of renal function, which hasa good relevance to glomerular filtration rate (GFR), and its performance is remarkablysuperior to the detecting of serum urea, creatinine and creatinine clearance rate. It wasrecently shown cystatin C play a role in inflammation, reconstruction of extracellularmatrix and formation of atherosclerotic plaque. However, the role of cystatin C inatherosclerosis remains to be not elucidated. We sought to assess whether serum cystatinC level can be independently associated with atherosclerosis and coronary heart disease(CHD).Methods:88patients with clinically suspected coronary artery disease underwentcoronary arterial angiography. Among the patients there were62cases with CHD,which were divided into two subgroups based on clinical manifestations: stable anginapectoris (SAP)(n=22) and acute coronary syndrome (ACS)(n=40), or divided into threesubgroups based on the number of diseased coronary vessels:28cases of single-vessellesions,14cases of double-vessel lesions and20cases of triple-vessel lesions, while26controls with normal coronary arteries were selected as control group. Clinical andbiochemical characteristics were collected. The serum samples were thawed andanalyzed for circulating cystatin C and matrix metalloproteinases-9(MMP-9) byenzyme linked immunosorbent assay (ELISA). The association of cystatin C withdifferent clinical types, numbers of diseased coronary vessels, and traditional riskfactors in CHD were determined.Results: Serum cystatin C levels were significantly lower in SAP ((911.21±171.25)ng/ml, P<0.05) and ACS ((781.24±172.56)ng/ml, P<0.05) than control patients((1148.33±254.18)ng/ml). The more coronary lesion was, the lower serum level ofcystatin C was (single-vessel lesions (944.10±131.97)ng/ml, double-vessel lesions(797.93±176.65)ng/ml, triple-vessel lesions (684.52±133.64)ng/ml, P<0.05). Multipleregression analysis demonstrated that serum cystatin C level was negatively correlatedwith MMP-9, TG and BMI (B values for MMP-9, TG, BMI were-172.372,-95.943,-20.258, respectively). Logistic regression analysis demonstrated that serum cystatin Clevels were closely associated with CHD following adjustment for established risk factors (OR=0.366).Conclusions:○1The level of serum cystatin C in patients with CHD is apparentlylower than the control group, while the level in ACS patients reduces more significantly.The change of the level of cystatin C could be taken as the reference index of ACSdiagnosis to some extent, and provide certain basis on clinical risk stratification of CHDpatients.○2With coronary lesions count increasing; the level of serum cystatin Cdecreases gradually. Moreover, the level of serum cystatin C and coronary lesions countare significantly negative correlation, and the level of serum cystatin could indirectlyreflect the severity of coronary artery disease.○3Serum cystatin C is negativelycorrelated with BMI and TG, and significantly positive correlated with HDL-C.