Cystatin-C in patients with acute coronary syndrome: Correlation with ventricular dysfunction, and affected coronary vessels
DOI:
https://doi.org/10.22317/jcms.v6i1.729Keywords:
Cystatin C, Acute coronary syndrome, left ventricular ejection fraction, coronary angiographyAbstract
Abstract
Objective: This study designed to inspect the circulating levels of Cy/C in patients with ACS and to evaluate the association of Cy/C levels with ejection fraction and angiographic number of stenosed coronaries.
Methods: 136 participants with ACS were enrolled in this case-control survey and compared with 94 control. Hematological assessments were done for all the participants and included Cy/C, creatinine and uric acid were measured using conventional technique. Creatinine clearance rate was calculated and Estimated glomerular-filtration-rate (eGFR) were measured. Echocardiographic assessment of ejection fraction was done with a cut-off-point <40 LVEF% designated for LV systolic dysfunction. Angiographic evaluation involved in this study depending on the severity of stenosed coronaries by calculating number of arteries display not less than 1 critical stenosis (designed as >70% decrease in caliber).
Results: Ejection fraction was significantly lower in in ACS patients than control group (p<0.05). Serum Cy/C was significantly higher in patients' group. The mean plasma uric acids values were significantly higher in patients' group (p-0.001) but with no significant differences in creatinine and creatinine clearance (p>0.05) observed between groups. The eGFR were significantly lower in ACS people compared to healthy persons. Correlation studies of Cy/C showed positive correlation with serum creatinine and serum uric acid; as well as non-significant negative correlation with eGFR (p>0.05).
Conclusion: Besides the role of Cy/C in early detection of renal dysfunction, it could have a role in diagnosis of ACS and evaluation of LV systolic dysfunction. Nevertheless, this study showed Cy/C was not related to the number of coronary arteries affected.
References
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16. Kyhse-Andersen J, Schmidt C, Nordin G, Andersson B, Nilsson-Ehle P, Lindstrom V, et al. Serum cystatin C, determined by a rapid, automated particle-enhanced turbidimetric method, is a better marker than serum creatinine for glomerular filtration rate. Clinical chemistry. 1994;40(10):1921-6.
17. Norlund L, Fex G, Lanke J, Von Schenck H, Nilsson JE, Leksell H, et al. Reference intervals for the glomerular filtration rate and cell-proliferation markers: serum cystatin C and serum beta 2-microglobulin/cystatin C-ratio. Scandinavian journal of clinical and laboratory investigation. 1997;57(6):463-70.
18. Ge C, Ren F, Lu S, Ji F, Chen X, Wu X. Clinical prognostic significance of plasma cystatin C levels among patients with acute coronary syndrome. Clin Cardiol. 2009;32(11):644-8.
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20. Eriksson P, Jones KG, Brown LC, Greenhalgh RM, Hamsten A, Powell JT. Genetic approach to the role of cysteine proteases in the expansion of abdominal aortic aneurysms. The British journal of surgery. 2004;91(1):86-9.
21. Shlipak MG, Katz R, Sarnak MJ, Fried LF, Newman AB, Stehman-Breen C, et al. Cystatin C and prognosis for cardiovascular and kidney outcomes in elderly persons without chronic kidney disease. Annals of internal medicine. 2006;145(4):237-46.
22. Keller T, Messow CM, Lubos E, Nicaud V, Wild PS, Rupprecht HJ, et al. Cystatin C and cardiovascular mortality in patients with coronary artery disease and normal or mildly reduced kidney function: results from the AtheroGene study. European heart journal. 2009;30(3):314-20.
23. Tayeh O, Rizk A, Mowafy A, Salah S, Gabr K. Cystatin-C as a predictor for major adverse cardiac events in patients with acute coronary syndrome. The Egyptian Heart Journal. 2012;64(3):87-95.
24. Shlipak MG, Matsushita K, Arnlov J, Inker LA, Katz R, Polkinghorne KR, et al. Cystatin C versus creatinine in determining risk based on kidney function. The New England journal of medicine. 2013;369(10):932-43.
25. Huang GX, Ji XM, Ding YC, Huang HY. Association between serum cystatin C levels and the severity or potential risk factors of acute ischemic stroke. Neurological research. 2016;38(6):518-23.
26. Harada M, Izawa A, Hidaka H, Nakanishi K, Terasawa F, Motoki H, et al. Importance of cystatin C and uric acid levels in the association of cardiometabolic risk factors in Japanese junior high school students. Journal of cardiology. 2017;69(1):222-7.
27. Latta F, de Filippi C. Role for Cystatin C-Based Risk Stratification for Patients After Acute Coronary Syndrome in the Era of High Sensitivity Cardiac Troponin Assays. Journal of the American Heart Association. 2018;7(20):e010589-e.
28. Muntner P, Mann D, Winston J, Bansilal S, Farkouh ME. Serum cystatin C and increased coronary heart disease prevalence in US adults without chronic kidney disease. The American journal of cardiology. 2008;102(1):54-7.
29. Lodh M, Parida A, Sanyal J, Ganguly A. Cystatin C in Acute Coronary Syndrome. Ejifcc. 2013;24(2):61-7.
30. Qing X, Furong W, Yunxia L, Jian Z, Xuping W, Ling G. Cystatin C and asymptomatic coronary artery disease in patients with metabolic syndrome and normal glomerular filtration rate. Cardiovascular diabetology. 2012;11:108.
31. Shuaila M, Abdulamir, Hassanain, Alshok, Monem. Prognostic value of cystatin C in acute coronary syndrome. Journal of Contemporary Medical Sciences. 2016;2(4):4.
32. Moran A, Katz R, Smith NL, Fried LF, Sarnak MJ, Seliger SL, et al. Cystatin C concentration as a predictor of systolic and diastolic heart failure. Journal of cardiac failure. 2008;14(1):19-26.
33. Sekizuka H, Akashi YJ, Kawasaki K, Yamauchi M, Musha H. Cystatin C: a better marker to detect coronary artery sclerosis. Journal of cardiology. 2009;54(3):359-67.
2. Huang Q, Shen W, Li J, Luo X, Shi H, Yan P, et al. Association of serum cystatin C levels with acute coronary syndrome in patients of advanced age. J Int Med Res. 2019;47(5):1987-97.
3. Mustafa Begenc Tascanov OY. May cystatin-c be associated with post-myocardial infarction complications? Journal of Clinical and Analytical Medicine. 2019;10:7.
4. Correa S, Morrow DA, Braunwald E, Davies RY, Goodrich EL, Murphy SA, et al. Cystatin C for Risk Stratification in Patients After an Acute Coronary Syndrome. Journal of the American Heart Association. 2018;7(20):e009077.
5. Wei L, Ye X, Pei X, Wu J, Zhao W. Reference intervals for serum cystatin C and factors influencing cystatin C levels other than renal function in the elderly. PLoS One. 2014;9(1):e86066-e.
6. Martucheli KFC, Domingueti CP. Clinical Usefulness of Cystatin C to Assess the Prognosis of Acute Coronary Syndromes: A Systematic Review and Meta-Analysis %J International Journal of Cardiovascular Sciences. 2018;31:290-307.
7. Shahbaz H GMUISIISI. Creatinine Clearance. 2019 2019 Jul 5 [cited Jan 7 2020]. StatPearls Publishing, [cited Jan 7 2020].
8. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Annals of internal medicine. 1999;130(6):461-70.
9. Mentzer G, Hsich EM. Heart Failure with Reduced Ejection Fraction in Women: Epidemiology, Outcomes, and Treatment. Heart failure clinics. 2019;15(1):19-27.
10. Amir S Al-Mumim aBMZ, Hayder AA Al-Hindy. Decayed Missed Filled Scores in Iraqi Patients with Acute Myocardial Infarction. Al-Kufa Journal for Biological Sciences. 2016;8 (3):5.
11. Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE, Jr., et al. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-Elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine. Journal of the American College of Cardiology. 2007;50(7):e1-e157.
12. Lodh M, Goswami B, Parida A, Patra S, Saxena A. Assessment of serum leptin, pregnancy-associated plasma protein A and CRP levels as indicators of plaque vulnerability in patients with acute coronary syndrome. Cardiovascular journal of Africa. 2012;23(6):330-5.
13. Nagesh CM, Roy A. Role of biomarkers in risk stratification of acute coronary syndrome. The Indian journal of medical research. 2010;132:627-33.
14. Sarnak MJ, Katz R, Stehman-Breen CO, Fried LF, Jenny NS, Psaty BM, et al. Cystatin C concentration as a risk factor for heart failure in older adults. Annals of internal medicine. 2005;142(7):497-505.
15. Parikh NI, Hwang SJ, Yang Q, Larson MG, Guo CY, Robins SJ, et al. Clinical correlates and heritability of cystatin C (from the Framingham Offspring Study). The American journal of cardiology. 2008;102(9):1194-8.
16. Kyhse-Andersen J, Schmidt C, Nordin G, Andersson B, Nilsson-Ehle P, Lindstrom V, et al. Serum cystatin C, determined by a rapid, automated particle-enhanced turbidimetric method, is a better marker than serum creatinine for glomerular filtration rate. Clinical chemistry. 1994;40(10):1921-6.
17. Norlund L, Fex G, Lanke J, Von Schenck H, Nilsson JE, Leksell H, et al. Reference intervals for the glomerular filtration rate and cell-proliferation markers: serum cystatin C and serum beta 2-microglobulin/cystatin C-ratio. Scandinavian journal of clinical and laboratory investigation. 1997;57(6):463-70.
18. Ge C, Ren F, Lu S, Ji F, Chen X, Wu X. Clinical prognostic significance of plasma cystatin C levels among patients with acute coronary syndrome. Clin Cardiol. 2009;32(11):644-8.
19. Bharat Lochan KBR. Cystatin-C as a potential risk factor for acute myocardial infarction with normal renal function. International Archives of Integrated Medicin. 2019;6(1):7.
20. Eriksson P, Jones KG, Brown LC, Greenhalgh RM, Hamsten A, Powell JT. Genetic approach to the role of cysteine proteases in the expansion of abdominal aortic aneurysms. The British journal of surgery. 2004;91(1):86-9.
21. Shlipak MG, Katz R, Sarnak MJ, Fried LF, Newman AB, Stehman-Breen C, et al. Cystatin C and prognosis for cardiovascular and kidney outcomes in elderly persons without chronic kidney disease. Annals of internal medicine. 2006;145(4):237-46.
22. Keller T, Messow CM, Lubos E, Nicaud V, Wild PS, Rupprecht HJ, et al. Cystatin C and cardiovascular mortality in patients with coronary artery disease and normal or mildly reduced kidney function: results from the AtheroGene study. European heart journal. 2009;30(3):314-20.
23. Tayeh O, Rizk A, Mowafy A, Salah S, Gabr K. Cystatin-C as a predictor for major adverse cardiac events in patients with acute coronary syndrome. The Egyptian Heart Journal. 2012;64(3):87-95.
24. Shlipak MG, Matsushita K, Arnlov J, Inker LA, Katz R, Polkinghorne KR, et al. Cystatin C versus creatinine in determining risk based on kidney function. The New England journal of medicine. 2013;369(10):932-43.
25. Huang GX, Ji XM, Ding YC, Huang HY. Association between serum cystatin C levels and the severity or potential risk factors of acute ischemic stroke. Neurological research. 2016;38(6):518-23.
26. Harada M, Izawa A, Hidaka H, Nakanishi K, Terasawa F, Motoki H, et al. Importance of cystatin C and uric acid levels in the association of cardiometabolic risk factors in Japanese junior high school students. Journal of cardiology. 2017;69(1):222-7.
27. Latta F, de Filippi C. Role for Cystatin C-Based Risk Stratification for Patients After Acute Coronary Syndrome in the Era of High Sensitivity Cardiac Troponin Assays. Journal of the American Heart Association. 2018;7(20):e010589-e.
28. Muntner P, Mann D, Winston J, Bansilal S, Farkouh ME. Serum cystatin C and increased coronary heart disease prevalence in US adults without chronic kidney disease. The American journal of cardiology. 2008;102(1):54-7.
29. Lodh M, Parida A, Sanyal J, Ganguly A. Cystatin C in Acute Coronary Syndrome. Ejifcc. 2013;24(2):61-7.
30. Qing X, Furong W, Yunxia L, Jian Z, Xuping W, Ling G. Cystatin C and asymptomatic coronary artery disease in patients with metabolic syndrome and normal glomerular filtration rate. Cardiovascular diabetology. 2012;11:108.
31. Shuaila M, Abdulamir, Hassanain, Alshok, Monem. Prognostic value of cystatin C in acute coronary syndrome. Journal of Contemporary Medical Sciences. 2016;2(4):4.
32. Moran A, Katz R, Smith NL, Fried LF, Sarnak MJ, Seliger SL, et al. Cystatin C concentration as a predictor of systolic and diastolic heart failure. Journal of cardiac failure. 2008;14(1):19-26.
33. Sekizuka H, Akashi YJ, Kawasaki K, Yamauchi M, Musha H. Cystatin C: a better marker to detect coronary artery sclerosis. Journal of cardiology. 2009;54(3):359-67.
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Published
2020-02-26
How to Cite
Abed, D. A., Jasim, R., Al-Hindy, H. A.-A., & Obaid, A. W. (2020). Cystatin-C in patients with acute coronary syndrome: Correlation with ventricular dysfunction, and affected coronary vessels. Journal of Contemporary Medical Sciences, 6(1), 26–31. https://doi.org/10.22317/jcms.v6i1.729
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