Larsen Trine R, Gerke Oke, Diederichsen Axel C P, Lambrechtsen Jess, Steffensen Flemming Hald, Sand Niels Peter, Antonsen Steen, Mickley Hans
a Department of Clinical Biochemistry , Svendborg Hospital , Svendborg , Denmark.
b Department of Nuclear Medicine , Odense University Hospital , Odense C , Denmark.
Scand J Clin Lab Invest. 2017 Dec;77(8):574-581. doi: 10.1080/00365513.2017.1355980. Epub 2017 Jul 27.
Cystatin C (CysC) is known to be related to cardiovascular disease (CVD), including the presence and severity of coronary artery disease (CAD) and future clinical events. In this study, the association between CysC levels and (1) coronary artery calcification (CAC) in asymptomatic individuals from the general population as well as (2) different subgroups of patients with suspected or definite acute myocardial infarction (MI) was investigated. CysC levels were measured in serum from asymptomatic individuals as part of a screening study for CAC using non-contrast cardiac CT scan (N = 1039) as well as in subgroups of hospitalized patients with a suspected MI (N = 769). CysC was not associated with CAC in asymptomatic individuals after adjusting for relevant risk factors. No difference in CysC levels was observed between patients with type 1 MI (1.07 mg/L) and patients with normal troponin (with or without prior CAD: 1.14 and 1.01 mg/L, respectively). However, patients with type 2 MI and patient subgroups with elevated troponin but without MI had significantly higher CysC levels (1.24, 1.23 and 1.31 mg/L), even after adjusting for other risk factors. CysC was not associated with CAC in middle-aged asymptomatic individuals from the general population. Furthermore, CysC levels were found to be significantly lower in patients with type 1 MI compared to patients with type 2 MI and patients with elevated troponins but without MI. Thus, in two independent and clinically different populations, no association between CysC and coronary atherosclerotic manifestations could be demonstrated.
胱抑素C(CysC)已知与心血管疾病(CVD)相关,包括冠状动脉疾病(CAD)的存在和严重程度以及未来的临床事件。在本研究中,调查了CysC水平与(1)一般人群无症状个体的冠状动脉钙化(CAC)以及(2)疑似或确诊急性心肌梗死(MI)患者的不同亚组之间的关联。作为使用非增强心脏CT扫描进行CAC筛查研究的一部分,测量了无症状个体血清中的CysC水平(N = 1039),以及疑似MI住院患者亚组中的CysC水平(N = 769)。在调整相关危险因素后,无症状个体中CysC与CAC无关。1型MI患者(1.07mg/L)与肌钙蛋白正常的患者(无论有无既往CAD:分别为1.14和1.01mg/L)之间未观察到CysC水平的差异。然而,2型MI患者以及肌钙蛋白升高但无MI的患者亚组,即使在调整其他危险因素后,CysC水平也显著更高(1.24、1.23和1.31mg/L)。普通人群中年无症状个体中CysC与CAC无关。此外,发现1型MI患者的CysC水平明显低于2型MI患者以及肌钙蛋白升高但无MI的患者。因此,在两个独立且临床情况不同的人群中,未证明CysC与冠状动脉粥样硬化表现之间存在关联。