Clinical Significance Of Serum Cystatin C In ACS Patients With Metabolic Syndrome

Objective: To evaluate the implications of Serum Cystatin C in ACS Patients with Metabolic Syndrome(MS),to provide basis for serum cystatin C as a new index for the prevention and treatment of ACS patients with MS.Methods:The study involved 539 patients diagnosed ACS and recieved coronary angiography,who hospitalized in the Department and Clinic of Cardiology at Guangxi Medical University in Guangxi,China,between September,2016 and December,2017.Among them,466 patients were diagnosed by coronary angiography.There were 148 patients with ACS-MS group and 318 patients with ACS-NMS group according to with or without metabolic syndrome.The normal control were 73 subjects.The patients' characteristics included age,sex,medical history(hypertension,diabetes,smoke),Systolic blood pressure(SBP),Diastolic blood pressure(DBP),body mass index(BMI)on admission were recorded during hospitalization.Blood samples were collected in the morning on the day after admission,and the cystatin(Cys C),fasting blood glucoseserum(FBG),postprandial blood glucose(PBG),low-density lipoprotein(LDL-c),Total cholesterol(TC),Triglyceride(TG),Serum creatinine(SCr),Glomerular Filtration Rate(eGRF),Fibrinogen(Fg),Homocysteine(Hcy)were measured.All patients recieved coronary angiography.According to coronary artery lesion vessel counts,it divided into three groups,including single vessel lesion,double vessel lesion and multiple vessel lesion.The changes of CysC levels were analyzed among ACS-MS group and ACS-NMS group.ACS patients were divided into low-risk(1?108 points),intermediate-risk(109?140 points),and high-risk groups(141 ? 372 points)using the global acute coronary event registration risk scoring system(GRACE score).Changes in CysC levels in low-risk,moderate-risk,and high-risk groups in patients with ACS-MS and ACS were analysised.Results:1.Compared with the normal control group,age,gender,eGFR in ACS-MS group and ACS-NMS group had no significant difference(P>0.05).Compared with the normal control group,Scr,BMI,smoking history,hyperglycemia,fibrinogen,and Hcy increased in a ACS-NMS group,and the difference was universal(P<0.05).Compared with the normal control group,Scr,BMI,smoking history,the proportion of hyperglycemia,the ratio of hyperlipidemia,Fg,Hcy,SBP and DBP were elevated in the ACS-MS group,and the difference was of significance(P<0.05).Compared with ACS-NMS group,BMI,hyperglycemia,hyperlipidemia ratio,SBP and DBP were elevated in the ACS-MS group,and the difference was of significance(P<0.05).2.The single vessel lesion proportion in ACS-NMS group was higher than that in ACS-NMS group,It was significantly different(P<0.01).The double vessel lesion proportion in ACS-MS group was higher than that in ACS-NMS group,but it was no significantly different(P>0.05).The multiplevessel lesion proportion in ACS-MS group was higher than that in ACS-NMS group.It was significantly different(P<0.05).3.The levels of CysC in ACS-MS group and ACS-NMS group were significantly higher than that in normal control group,and the difference was statistically significant(P<0.001).The levels of CysC in ACS-MS group were significantly higher than those in ACS-NMS group.It was significantly different(P<0.001).4.The Cys C levels of single vessel lesion in ACS-MS group were higher than those in ACS-NMS group,but it was no significantly different(P>0.05).The CysC levels of double vessel lesion and multiple vessel lesion in ACS-MS group were higher than those in ACS-NMS group.It was significantly different(P<0.01).5.The GRACE score in ACS-MS group is higher than ACS-NMS group.It was significantly different(P<0.05).6.The levels of Cys C in low-risk,moderate-risk and high-risk groups of ACS-MS group were significantly higher than those in ACS-NMS group,and the difference was statistically significant(P<0.05).7.Multi factor classification of Binary Logistic regression of the whole,found BMI,hyperglycemia,hyperlipidemia,CysC were positively correlated with ACS-MS,where the risk of semm CysC was 17.03(P=0.000).8.The area under the ROC curve of CysC in patients with ACS with metabolic syndrome was 0.799,which was statistically significant compared with 0.5(P<0.001).With a standard Cys C level of 0.523 mg/l,the sensitivity for the diagnosis of acs+ms was 68.7% and the specificity was 83.5%.CysC has value in predicting and diagnosing ACS patients with metabolic syndrome.Conclusion:ACS patients with metabolic syndrome may have higher risk of coronary vasculopathy,higher serum Cys C levels and GRACE scores.Serum cystatin C is associated with ACS patients with metabolic syndrome.Cys C may be one of the early detection indicators of ACS with metabolic syndrome.