Atherosclerosis

2008

DOI: 10.1016/j.atherosclerosis.2007.09.022

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Cystatin C is associated with an increased coronary atherosclerotic burden and a stable plaque phenotype in patients with ischemic heart disease and normal glomerular filtration rate

Giampaolo Niccoli¹,

Micaela Conte²,

Roberta Della Bona³

et al.

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Discussion2

Direct Role Of Cysc In the Arterial Wall1

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Cited by 52 publications

(55 citation statements)

References 31 publications

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“…Based on the fact that their GFR was normal (≥90 ml · min -1 · 1.73 m -2 ), Cys C was thought to play some role in plaque formation. 33 Our study, however, demonstrated no clear relationship between Cys C and the number of stenotic coronary arteries in patients with normal renal function, and provided no evidence of a direct relationship between Cys C and arteriosclerosis.…”

Section: Discussionmentioning

confidence: 42%

Plasma Cystatin C Concentration Reflects the Severity of Coronary Artery Disease in Patients Without Chronic Kidney Disease

¹

,

²

,

³

et al. 2010

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Background: 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). Methods and Results: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. Conclusions: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. (Circ J 2010; 74: 2441 - 2447

“…Based on the fact that their GFR was normal (≥90 ml · min -1 · 1.73 m -2 ), Cys C was thought to play some role in plaque formation. 33 Our study, however, demonstrated no clear relationship between Cys C and the number of stenotic coronary arteries in patients with normal renal function, and provided no evidence of a direct relationship between Cys C and arteriosclerosis.…”

Section: Discussionmentioning

confidence: 42%

Plasma Cystatin C Concentration Reflects the Severity of Coronary Artery Disease in Patients Without Chronic Kidney Disease

¹

,

²

,

³

et al. 2010

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Background: 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). Methods and Results: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. Conclusions: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. (Circ J 2010; 74: 2441 - 2447

“…This result, which needs to be confirmed on larger studies, may confirm the role of CysC in vascular remodelling, including that which occurs in coronary disease. The possible consequences of changes in arterial wall CysC expression on circulating concentrations remain to be defined (237).…”

Section: Direct Role Of Cysc In the Arterial Wallmentioning

confidence: 99%

Cystatin C: current position and future prospects

Séronie-Vivien

¹

,

²

,

et al. 2008

Clinical Chemistry and Laboratory Medicine

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Cystatin C is a low-molecular-weight protein which has been proposed as a marker of renal function that could replace creatinine. Indeed, the concentration of cystatin C is mainly determined by glomerular filtration and is particularly of interest in clinical settings where the relationship between creatinine production and muscle mass impairs the clinical performance of creatinine. Since the last decade, numerous studies have evaluated its potential use in measuring renal function in various populations. More recently, other potential developments for its clinical use have emerged. This review summarises current knowledge about the physiology of cystatin C and about its use as a renal marker, either alone or in equations developed to estimate the glomerular filtration rate. This paper also reviews recent data about the other applications of cystatin C, particularly in cardiology, oncology and clinical pharmacology. Clin Chem Lab Med 2008;46:1664-86.

“…The long-term prognostic role of cystatin C might be accounted for by a greater atherosclerotic burden-a necessary substrate for plaque destabilization. 4 Our research is a cohort study to prospectively investigate the association of plasma cystatin C levels and ACS.…”

Section: Introductionmentioning

confidence: 99%

Clinical Prognostic Significance of Plasma Cystatin C Levels among Patients With Acute Coronary Syndrome

¹

,

²

,

³

et al. 2009

Clinical Cardiology

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Background: This article aims to investigate the changes of plasma cystatin C concentration (PcyC), and to evaluate the relationship between PcyC and acute coronary syndrome. Methods: A total of 126 consecutive patients with coronary artery disease (CAD) were enrolled in this study, consisting of 34 patients with stable angina pectoris (SAP), 56 patients with unstable angina pectoris (UAP), 36 patients with acute myocardial infarction (AMI), and 34 healthy subjects as controls. Plasma cystatin C, high sensitivity C-reactive protein (hs-CRP), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and uric acid (UA) in all subjects were determined. All patients were followed up for 6 months and adverse cardiovascular events were recorded. Results: Plasma cystatin C was elevated in CAD. Cystatin C levels were significantly higher in UAP patients than those in SAP patients and controls (2013.83 ± 633.85 ng/mL vs 1348.41 ± 369.62 ng/mL and 1509.99 ± 408.65 ng/mL, P < 0.05), but were much lower than those in AMI patients (2013.83 ± 633.85 ng/mL vs 2873.55 ± 1149.48 ng/mL, P < 0.05). Patients with AMI also exhibited significantly higher cystatin C levels than SAP patients and the control group (2873.55 ± 1149.48 ng/mL vs 1348.41 ± 369.62 ng/mL and 1509.99 ± 408.65 ng/mL, P < 0.01). Much higher hs-CRP concentrations were found in UAP patients (1.58 ± 2.81 mg/L, P < 0.05) and AMI patients (20.68 ± 18.98 mg/L, P < 0.01). Cystatin C was positively and significantly correlated with age, hs-CRP, white blood cells (WBC), creatinine, and UA (r > 0, P < 0.05), whereas a significantly negative correlation was observed with HDL-C (r = −0.227, P < 0.05). These coefficients were clearly high for creatinine (r = +0.612) and WBC (r = +0.459). During the 6 month followup, 26 patients were found with adverse cardiovascular events and had significantly higher cystatin C levels than the 22 control patients at admission (2356.73 ± 897.64 ng/mL vs 1469.51 ± 574.83 ng/mL, P < 0.01). Conclusions: Cystatin C plays an important role in the development of CAD and PcyC is a strong predictor for risk of cardiovascular events.

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