Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print), ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2014, vol. 23, nr 4, July-August, p. 551–558

Publication type: original article

Language: English

Evaluation of the Significance of Cystatin C Levels in Patients Suffering from Coronary Artery Disease

Marta Negrusz-Kawecka1,A,B,D,E,F, Rafał Poręba2,C,E,F, Anna Hulok1,A,B,D,E,F, Krzysztof Ściborski1,A,B,D,E,F, Jakub Marczak3,4,C,D,E,*, Tomasz Bańkowski1,A,C,D,E,F

1 Department and Clinic of Cardiology, Wroclaw Medical University, Poland

2 Department and Clinic of Internal Medicine, Occupational Diseases and Hypertension, Wroclaw Medical University, Poland

3 Department and Clinic of Cardiac Surgery, Wroclaw Medical University, Poland

4 Department of Cardiac Surgery, Medinet Heart Center Ltd., Nowa Sól, Poland

Abstract

Objectives. Cystatin C is a novel marker used in the diagnosis of preclinical chronic kidney disease (CKD). The aim of the study was to assess the role of cystatin C in the diagnosis of coronary artery disease.
Material and Methods. The study involved 63 patients of a mean age of 62.7 ± 9.5 years. The population was divided into two groups: Group I were patients with angiographically diagnosed coronary artery disease (CAD) with their first acute coronary syndrome (ACS, n = 45); Group II were patients who had clinically diagnosed coronary disease but were negative on angiography (n = 18). Cystatin C levels were measured before angiography in both groups; in Group I they were also measured 6 months after discharge.
Results. Cystatin C levels were significantly higher in Group I (p = 0.01), and this depended on the type of CAD: non-ACS, non-ST elevated myocardial infarction (NSTEMI) or ST elevated myocardial infarction (STEMI) (p = 0.01). Cystatin C levels correlated inversely with the left ventricular ejection fraction in the whole study population (p = 0.003) and in patients with NSTEMI (p = 0.03). A high cystatin C level was found to be a risk factor for ACS (OR: 1.002 95% CI [1.00029–1.004], p = 0.02) and STEMI (OR: 1.0009 95% CI [0.99–1.002], p = 0.04) but not for NSTEMI (OR: 0.99 95% CI [0.99–1.0], p = 0.21. A ROC analysis revealed that there is a significantly higher risk of ACS above a cystatin C level of 727.85 ng/mL (OR: 5.5 CI [1.65–18.3], p = 0.004) and a significantly higher risk of STEMI above 915.22 ng/mL (OR: 5.9 CI [1.7–19.7], p = 0.003).
Conclusion. The available data suggest that a high cystatin C level is a risk factor for ACS and STEMI. This could play an important role in the early diagnosis and prevention of adverse cardiovascular events.

Key words

cystatin C, coronary artery disease, STEMI, NSTEMI, acute coronary syndrome, risk factor.

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