Department of Cardiology, Pulmonology and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
Circ J. 2011;75(10):2439-44. doi: 10.1253/circj.cj-11-0008. Epub 2011 Jul 23.
Cystatin C, a marker for early stage chronic kidney disease, has been shown to be involved in cardiovascular disease. The relationship between serum cystatin C levels and coronary vasospastic angina (VSA), however, remains to be elucidated. The aim of the present study was to investigate whether elevated cystatin C levels predict the incidence of VSA.
One hundred and ten patients were referred to hospital due to suspected VSA. VSA was evoked in 59 patients by a vasospasm provocation test with administration of acetylcholine into the coronary arteries. The patients with VSA had lower levels of high-density lipoprotein cholesterol and a higher history of cigarette smoking, higher levels of triglyceride, high-sensitivity C-reactive protein, and higher cystatin C levels compared with those without VSA. There were no differences in serum creatinine or estimated glomerular filtration rate between patients with and without VSA. Multivariate logistic regression indicated that history of smoking (odds ratio, 2.956 P<0.05) and cystatin C levels (odds ratio, 2.285; P<0.01) were independently associated with the incidence of VSA.
Elevated cystatin C levels were associated with higher incidence of VSA, suggesting that mild renal dysfunction may be implicated in the pathogenesis of coronary artery spasm.
胱抑素 C 是早期慢性肾脏病的标志物，它与心血管疾病有关。然而，血清胱抑素 C 水平与冠状动脉痉挛性心绞痛（VSA）之间的关系仍有待阐明。本研究旨在探讨胱抑素 C 水平升高是否可预测 VSA 的发生。
110 例疑似 VSA 的患者被收入院。59 例患者通过冠状动脉内乙酰胆碱注射诱发血管痉挛激发试验诱发 VSA。与无 VSA 的患者相比，VSA 患者的高密度脂蛋白胆固醇水平较低，吸烟史较高，甘油三酯、高敏 C 反应蛋白和胱抑素 C 水平较高。VSA 患者与无 VSA 患者的血清肌酐或估计肾小球滤过率无差异。多变量 logistic 回归表明，吸烟史（比值比，2.956；P<0.05）和胱抑素 C 水平（比值比，2.285；P<0.01）与 VSA 的发生独立相关。
胱抑素 C 水平升高与 VSA 发生率增加相关，表明轻度肾功能障碍可能与冠状动脉痉挛的发病机制有关。
