Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Circ J. 2010 Nov;74(11):2441-7. doi: 10.1253/circj.cj-10-0158. Epub 2010 Sep 29.
This study examines whether the serum concentration of cystatin C (Cys C) correlates with the severity of coronary artery disease (CAD) and whether it provides additional information on the risk for CAD in patients without chronic kidney disease (CKD) estimated by the creatinine-based glomerular filtration rate (GFR).
The relationship between serum Cys C and the severity of CAD in 526 patients was investigated. Based on GFR, patients were divided into those with and without CKD. The relationship of serum Cys C with the severity of CAD was examined. Serum Cys C was closely correlated with GFR in all cases and in CKD patients, but not in non-CKD patients. The average number of stenotic coronary arteries was significantly higher in the quartiles of higher concentration of Cys C as well as in those of GFR. In 348 patients (66%) the GFR was ≥60 ml · min(-1)·1.73 m(-2). Those patients with increased Cys C (>0.90 mg/L, 143 patients) had a significantly larger number of stenotic coronary arteries than those patients with normal Cys C.
Among patients considered to be at low risk based on the estimated GFR using serum creatinine, those with high concentrations of Cys C could have severe CAD. Besides CKD, Cys C might serve as a marker of CAD severity.
本研究旨在探讨血清胱抑素 C（Cys C）浓度与冠状动脉疾病（CAD）严重程度的相关性，以及在基于肌酐的肾小球滤过率（GFR）估计的无慢性肾脏病（CKD）患者中，其是否为 CAD 风险提供了额外信息。
研究分析了 526 例患者的血清 Cys C 与 CAD 严重程度的关系。根据 GFR，将患者分为 CKD 组和非 CKD 组。检测血清 Cys C 与 CAD 严重程度的关系。结果显示，在所有患者和 CKD 患者中，血清 Cys C 与 GFR 密切相关，但在非 CKD 患者中无相关性。Cys C 浓度较高的四分位数以及 GFR 水平较高的患者，狭窄冠状动脉的平均数量明显更高。在 348 例（66%）GFR≥60 ml·min(-1)·1.73 m(-2)的患者中，Cys C 升高（>0.90 mg/L，143 例）的患者狭窄冠状动脉数量明显多于 Cys C 正常的患者。
在基于血清肌酐估计的 GFR 认为是低危的患者中，Cys C 浓度较高的患者可能患有严重的 CAD。除 CKD 外，Cys C 可能也是 CAD 严重程度的标志物。
