Assessing The Relevance Of Serum Cystatin C,Urinary Albumin To Creatinine Ratio For Predicting The Severity Of Coronary Artery Lesions

Objective:To analyze the relationship between serum cystatin C(Cys C)and urinary microalbumin/urinary creatinine(UACR)levels and the severity of coronary artery disease(CAD),and to explore the predictive value of the two methods for coronary artery disease in patients with basically normal renal function.Methods: A total of 270 patients with CAG positive hospitalized in The Department of Cardiology,Shenyang Jishuitan Hospital from October 2019 to December 2020 were enrolled as the study group,and 80 patients with normal CAG during the same period were enrolled as the control group.Based on SYNTAX score,270 patients in the study group were divided into low-risk group(124 cases),medium-risk group(80 cases)and high-risk group(66 cases).In addition,CHD patients were further divided into three groups according to the number of target vessels:single vessel group(93 cases),double vessel group(101 cases)and three vessel group(76 cases).General clinical data registration and routine biochemical indicators were completed for each group,and the following renal function indicators were recorded: Serum creatinine(Cr)and urinary creatinine were measured by enzyme method,Cys C and urinary microalbumin were measured by immunoturbidimetry,UACR and glomerular filtration rate(e GFR)were calculated,and renal function indexes among different groups were compared.To explore the relationship between Cys C and UACR,SYNTAX score and the number of coronary artery lesions,and Logistic regression analysis of multi-vessel lesions to explore the relationship between Cys C and UACR and coronary artery multi-vessel lesions.Results: The serum cystatin C levels in control group,low-risk group,medium-risk group and high-risk group were gradually increased(P < 0.05).The level of urinary microalbumin/creatinine was in the normal range compared with the control group and the low-risk group,with no statistical difference(P > 0.05).However,UACR of these two groups,intermediate risk group and high risk group increased gradually,P < 0.05,indicating a significant statistical difference.The results of middle and high risk groups increased gradually,P < 0.05;The low risk group was lower than the medium risk group,and the medium risk group was lower than the high risk group,P < 0.05,indicating significant statistical difference.Cr levels did not differ significantly among the four groups(P>0.05).Compared with the control group,the three groups had relatively higher levels of e GFR(P<0.05),whereas no significant difference among the three groups.Comparisons were made between single,double and triple vessel groups,there was a significant increase in the Cys C and UACR(P<0.05).The blood Cr level in the threevessel disease group was higher than that in the single-vessel disease group and doublevessel disease group,with significant statistical difference(P < 0.05).EGFR level in the three-vessel group was lower than that in the single-vessel group and the two-vessel group,and the difference was statistically significant(P < 0.05).Logistic regression analysis showed that Cys C(OR = 1.220,95%[confidence interval,CI]: 1.095-1.358,P <0.05)and UACR(OR = 1.021,95% CI: 1.015-1.028,P <0.05)were independent risks.The main cause of MVD(Multiple Vascular Disease).The Cys C and UACR showed considerable predictive value to identify MVD with area under the curve(AUC)0.659(95%CI: 0.594-0.724,P<0.05)and 0.820(95%CI: 0.771-0.870,P<0.05),respectively.Conclusion:1.Serum cystatin C and urinary microalbumin/creatinine levels increased gradually with the increase of coronary artery disease severity.2.Serum cystatin C and urinary microalbumin/urinary creatinine levels have reference value for predicting the severity of coronary artery disease in patients with normal renal function.