Cystatin C is Associated With Plaque Phenotype and Plaque Burden

Wen, Yufeng; Xia, Dan; Wang, Yanchun; Zhang, Huiping; Li, Haibo; Ali, Gholam; Gao, Yongqing; Li, Jian; Sun, Wenjie; Li, Linlin

doi:10.1159/000443422

Cited by 8 publications

(8 citation statements)

References 46 publications

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“…Since biomarkers are proposed for risk stratification due to their relative ease of use, high-sensitivity cardiac troponin T (hs-cTnT) [ 11 – 13 ], NT-proBNP [ 14 ], Cystatin C [ 15 ], serum matrix metalloproteinase-9 [ 16 ], and lipoprotein-associated phospholipase A2 [ 17 ] have been considered closely related with coronary plaque morphology. Of note, a recent study revealed that the low-density lipoprotein-cholesterol/high-density lipoprotein-cholesterol (L/H) ratio independently had a significant fixed effect with the percentage of the lipid component of coronary plaques [ 18 ] and a high L/H ratio was reported closely associated with larger numbers of low density noncalcified plaque [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Low- to high-density lipoprotein cholesterol ratio followed by coronary computed tomography angiography improves coronary plaque classification accuracy

Zhang²,

Zhao

et al. 2017

Oncotarget

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Coronary computed tomography angiography (CCTA) is a noninvasive test for detection and analysis of coronary plaques morphology and classification. The low- to high-density lipoprotein cholesterol (L/H) ratio is associated with plaques vulnerability. The study aims to investigate the diagnostic accuracy of CCTA and L/H ratio for plaques classification. We enrolled 212 patients with coronary artery single-vessel disease who performed preoperative CCTA and Intravascular ultrasound (IVUS)-guided invasive coronary angiography. Patients were assigned to the acute coronary syndrome (ACS) group (n = 129) and stable angina pectoris (SAP) group (n = 83). CCTA showed that patients with ACS had more soft plaque and less calcific plaque than those with SAP. The plaque volume and remodeling index measured by CCTA showed good correlation with those measured by IVUS. IVUS identified 91 soft, 58 mixed and 63 calcific plaques in this cohort. For diagnosis of noncalcified plaque (soft and mixed), CCTA had the sensitivity and specificity of 87.9% and 90.4%, respectively. While refer to the further diagnosis of mixed plaque from noncalcified plaque, the sensitivity and specificity was 88.4% and 88.8%, respectively. The L/H ratio was gradually decreased from soft plaque to calcific plaque. If the patients had both the two characteristics (L/H ≥ 2.55 and CCTA), the sensitivity, and specificity were improved in diagnosing noncalcified plaque or mixed plaque. In conclusion, a combined application of CCTA and L/H ratio improves the diagnostic accuracy for coronary noncalcified plaque or mixed plaque as compared to CCTA along.

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Section: Introductionmentioning

confidence: 99%

Low- to high-density lipoprotein cholesterol ratio followed by coronary computed tomography angiography improves coronary plaque classification accuracy

Zhang²,

Zhao

et al. 2017

Oncotarget

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“…One of previous studies had reported that cystatin C level was superior to many biomarkers studied for identifying patients with subclinical atherosclerosis as defined by arterial wall elas ticity [6] . Other studies had reported a significant association between serum cystatin C level and carotid atherosclerosis as assessed by maximum carotid plaque thickness [7] or by atherosclerotic plaque burden [8] . Additionally, a study had reported that cystatin C level was a strong and independent predictor of overall mortality as well as mortality and morbidity from CVD among the elderly [9] .…”

Section: Discussionmentioning

confidence: 97%

Assessment of serum cystatin C level in type 2 diabetic patients with early carotid atherosclerosis

Abbas¹,

Issa²,

Rahmah³

et al. 2021

ASRO

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Background: Coronary heart disease (CHD) is prevalent in type 2 diabetes mellitus (T2DM) where atherosclerotic plaques tend to be more severe and extensive and to affect multiple coronary arteries compared to age-matched non diabetic patients. Cystatin C is an abundant inhibitor of cysteine proteasesand might be involved in development of atherosclerosis . Objectives: To measure serum levels of cystatin C in type 2 diabetic patients with high carotid intima-media thickness (CIMT) and study its association with other atherosclerosis risk factors like hypertension, obesity, and dyslipidemia. Patients &Methods: This cross-sectional study enrolled 88 T2DM patients (males &females) for whom CIMT value were measured by B-mode ultrasonography and a CIMT value of> 0.89 mm was considered as high. Forty four patients were randomly selected with a high CIMT value and 44 patie nts with a normal CIMT value. For each study patient, clinical characteristics were recorded and serum cystatin C level was measured in addition to basic laboratory tests that included serum glucose, urea, creatinine, and lipids. An estimation of glomerular filtration rate (eGFR) was also done. Results: There was a highly significant increase of serum cystatin C level in high CIMT patients compared to normal CIMT patients (P< 0.001). The high CIMT patients also had a highly significant increase in triglycerides (P< 0.000) and a significant decrease in high-density lipoprotein cholesterol (P < 0.026). Their cystatin C levels showed a significant and a positivecorrelation with CIMT values (r = 0.233, P < 0.029). Comparison of cystatin Cand CIMT values of study patients according to their eGFR revealed significantly higher values in patients with mildly reduced eGFR compared to those with normal eGFR (13.30 ± 2.80 vs. 12.18 ± 2.38 ng/L, P < 0.0357, and 0.8385 ± 0.2178 vs. 0.6723 ± 0.1331 mm, P < 0.017, respectively). Cystatin C levels had no significant correlations with CIMT values in patients with mildly reduced eGFR. Conclusion: Serum cystatin C levels are significantly increased in high CIMT patients compared to normal CIMT patients and the levels had no significant correlations with CIMT values in patients with mildly reduced eGFR referring to a probable role for cystatin C in atherosclerosis independent of renal function. The further finding of significant correlations between CIMT and some risk factors of atherosclerosis like age, body mass index and diastolic blood pressure may indirectly suggest a role for cystatin C in pathogenesis of atherosclerosis.

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“…Plasma CysC levels are strongly associated with an increased risk of CAD, particularly for secondary CAD events 28 , 29 , 38 ) . Wen et al have reported the relationship between serum CysC levels and the presence of a carotid plaque 30 ) . Therefore, serum CysC and intracellular CysC should have different functions in atherosclerotic mechanisms, i.e., serum CysC may cause a reduction in serum APN clearance and suppress the vasculoprotective effects of APN through the formation of the CysC–APN complex, which can explain the paradox that hyperadiponectinemia is associated with increased CAD risk in patients with renal impairment 39 ) .…”

Section: Discussionmentioning

confidence: 99%

“…Elevated serum CysC levels indicate an increasing risk for cardiovascular events in subjects regardless of renal dysfunction 28 , 29 ) . We have previously reported that CysC reduces the clearance of plasma APN, leading to the inhibition of APN-mediated vasculoprotective effects 19 ) , and a recent report has demonstrated that serum CysC levels might be linked to carotid plaque size and instability 30 ) . However, the clinical significance of the CysC–APN complex on plaque vulnerability is still unknown.…”

Section: Introductionmentioning

confidence: 99%

Cystatin C–Adiponectin Complex in Plasma Associates with Coronary Plaque Instability

Matsumoto

Yamamoto

Matsuoka

et al. 2017

JAT

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Aim: Adiponectin (APN) is an adipocyte-derived bioactive molecule with antiatherogenic properties. We previously reported that cystatin C (CysC) abolished the anti-atherogenic effects of APN. We aimed to elucidate the clinical significance of CysC–APN complex in patients with coronary artery disease (CAD).Methods: We enrolled 43 stable CAD male patients to examine the relationship between CysC–APN complex and coronary plaque characteristics. Serum was immunoprecipitated by the anti-APN antibody and immunoblotted by the anti-CysC antibody to demonstrate the presence of CysC–APN complexes in vivo. To confirm their binding in vitro, HEK293T cell lysates overexpressing myc-APN and FLAG-CysC were immunoprecipitated with an anti-myc or anti-FLAG antibody, followed by immunoblotting with an anti-APN or anti-CysC antibody.Results: CysC was identified as a specific co-immunoprecipitant with APN by the anti-APN antibody in human serum. In vitro, FLAG-CysC was co-immunoprecipitated with myc-APN by the antimyc antibody and myc-APN was co-immunoprecipitated with FLAG-CysC by the anti-FLAG antibody. Among CAD patients, serum CysC–APN complex levels negatively correlated with fibrotic components of coronary plaques and positively correlated with either necrotic or lipidic plus necrotic components. Plaque burden negatively correlated with serum APN levels but not serum CysC–APN complex levels. Serum CysC levels had no association with plaque characteristics. In multivariate analysis, CysC–APN complex levels were identified as the strongest negative factor for fibrotic components and the strongest positive factor for both necrotic and lipidic plus necrotic components.Conclusion: Measuring serum CysC–APN complex levels is helpful for evaluating coronary plaque instability in CAD patients.

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Cystatin C is Associated With Plaque Phenotype and Plaque Burden

Cited by 8 publications

References 46 publications

Low- to high-density lipoprotein cholesterol ratio followed by coronary computed tomography angiography improves coronary plaque classification accuracy

Low- to high-density lipoprotein cholesterol ratio followed by coronary computed tomography angiography improves coronary plaque classification accuracy

Assessment of serum cystatin C level in type 2 diabetic patients with early carotid atherosclerosis

Cystatin C–Adiponectin Complex in Plasma Associates with Coronary Plaque Instability

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