Association of cystatin C with coronary artery calcification in patients undergoing multidetector computed tomography

Abstract

Cystatin C is associated with atherosclerosis, but the relationship between cystatin C and coronary artery calcification (CAC) is uncertain. The purpose of this study was to evaluate the predictive value of cystatin C on the occurrence and severity of CAC.A total of 1447 hospitalized patients with coronary computed tomography angiography were selected in this study. According to the CAC score (CACS), patients were divided into calcification group (with CAC, n = 749) and control group (without CAC, n = 698). The calcification group was further divided into low calcification group (CACS < 100, n = 407), medium calcification group (CACS 100-400, n = 203), and high calcification group (CACS≥400, n = 139).Patients with CAC had higher cystatin C level than those in control group (P < .05). With the increase of calcification score, the cystatin C level showed an upward trend. The cystatin C level in the high calcification group was significantly higher than those in the low and medium calcification group (P < .05). ROC curve analysis showed that cystatin C had a high predictive value for the occurrence of CAC [area under the curve 0.640, 95% confidence interval (95% CI) 0.591-0.690, cut-off value 0.945 mg/L, sensitivity 0.683, specificity 0.558, P < .05] and severe CAC (area under the curve 0.638, 95% CI 0.550-0.762, cut-off value 0.965 mg/L, sensitivity 0.865, specificity 0.398, P < .05). Multivariate logistic regression analysis showed that cystatin C was an independent predictor of severe CAC (AOR 3.748, 95% CI 1.138-10.044, P < .05).Cystatin C was significantly associated with the occurrence and severity of CAC, suggesting that cystatin C had the potential as a predictor of CAC. Abbreviations: AOR = adjusted odd ratio, CAC = coronary artery calcification, CACS = coronary artery calcification score, CI = confidence interval, CysC = Cystatin C, eGFR = estimated glomerular filtration rate, IL-6 = interleukin-6, LAD = left anterior descending, LCX = circumflex, LM = left main, MDRD = modification of diet in renal disease trial, OPG = osteoprotegerin, p38MAPK = p38 mitogen-activated protein kinase, RANK = receptor activator of nuclear factor-kB, RANKL = RANK ligand, RCA = right coronary artery, ROC = receiver operating characteristic, TNF-a = tumor necrosis factor-a.

Single-Cell Analysis Uncovers Osteoblast Factor Growth Differentiation Factor 10 as Mediator of Vascular Smooth Muscle Cell Phenotypic Modulation Associated with Plaque Rupture in Human Carotid Artery Disease

“…The top differentially expressed genes of cluster 0 include osteoblast factor GDF10 (BMP-3b), shown to regulate cell differentiation, skeletal morphogenesis [55], ossification, osteoblast differentiation [56][57][58], and linked to increased Alkaline Phosphatase activity [56]. In addition, cluster 0 expressed Serpinf1, involved in ossification and osteoblast differentiation [59], Hsd11b1, shown to exacerbate atherosclerosis [60], Pex5l, expressed in macrophages [61] and Gfra2 in monocytes [62], as well as cystatin C, associated with coronary artery calcification [63] (Figure 5a,b and Supplementary Figure S4a). Differentially expressed genes of cluster 0 are linked to cholesterol efflux (Abca8) [44] and induction of chondrogenesis (Itgbl1) [64] (Supplementary Figure S4a).…”