Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao Miyamae-ku, Kawasaki-City, Kanagawa, 216-8511 Japan.
J Cardiol. 2009 Dec;54(3):359-67. doi: 10.1016/j.jjcc.2009.06.003. Epub 2009 Jul 30.
Nowadays, early detection and treatment can often keep chronic kidney disease patients from getting worse and prevent the occurrence of cardiovascular disease. Cystatin C (Cys-C) is a new marker for renal dysfunction. This study investigated whether Cys-C played an important role for screening coronary artery disease.
The consecutive 88 outpatients (51 males and 37 females), who were suspected of having effort angina pectoris or asymptomatic ischemic heart disease, were enrolled. Serum Cys-C, which was obtained within 3 months before coronary angiography, was assessed with the presence or absence of coronary arteriosclerosis, the number of culprit arteries, and blood biochemical parameters.
Mean serum Cys-C was 0.82+/-0.29 mg/l. Significant differences in the estimated creatinine clearance (p=0.036), hemoglobin A1c (p=0.01), left ventricular ejection fraction (p=0.01), creatinine (p=0.007), Cys-C (p=0.006), and high-density lipoprotein (HDL) cholesterol (p=0.001) were observed between the patients with or without coronary arteriosclerosis. Serum Cys-C was significantly greater in the multi-vessel disease (MVD) group than the 0 vessel disease (0VD) group (p<0.001). HDL cholesterol was significantly lower in the MVD group than the 0VD and single-vessel disease groups (p=0.002 and p=0.005, respectively).
The results of this study suggest Cys-C might be one of the risk factors for coronary arteriosclerosis in the patients with suspected ischemic heart disease without any history of coronary artery disease. Cys-C was a useful marker to detect coronary artery disease and the level of Cys-C could reflect the severity of coronary arteriosclerosis.
如今，早期发现和治疗常常可以使慢性肾脏病患者病情不再恶化，并预防心血管疾病的发生。胱抑素 C（Cys-C）是一种新的肾功能障碍标志物。本研究旨在探讨 Cys-C 是否对筛查冠状动脉疾病有重要作用。
连续纳入 88 例疑似劳力性心绞痛或无症状缺血性心脏病的门诊患者（男 51 例，女 37 例）。在冠状动脉造影前 3 个月内检测血清 Cys-C，评估其与冠状动脉粥样硬化、罪犯血管数量和血液生化参数的关系。
平均血清 Cys-C 为 0.82±0.29mg/L。与无冠状动脉粥样硬化患者相比，有冠状动脉粥样硬化患者的估算肾小球滤过率（p=0.036）、糖化血红蛋白（HbA1c）（p=0.01）、左心室射血分数（LVEF）（p=0.01）、肌酐（p=0.007）、Cys-C（p=0.006）和高密度脂蛋白胆固醇（HDL-C）（p=0.001）差异均有统计学意义。多支血管病变（MVD）组的血清 Cys-C 显著高于 0 支血管病变（0VD）组（p<0.001）。MVD 组的 HDL-C 显著低于 0VD 组和单支血管病变组（p=0.002 和 p=0.005）。
本研究结果提示，对于无冠心病病史的疑似缺血性心脏病患者，Cys-C 可能是冠状动脉粥样硬化的危险因素之一。Cys-C 是一种有用的检测冠状动脉疾病的标志物，其水平可以反映冠状动脉粥样硬化的严重程度。
