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Serum Cystatin C Reflects Angiographic Coronary Collateralization in Stable Coronary Artery Disease Patients with Chronic Total Occlusion.

Shen Y, Ding FH, Zhang RY, Zhang Q, Lu L, Shen WF - PLoS ONE (2015)

Bottom Line: In total, serum cystatin C was higher in patients with poor collateralization than in those with good collateralization (1.08 ± 0.32 mg/L vs. 0.90 ± 0.34 mg/L, P < 0.001), and correlated inversely with Rentrop score (adjusted Spearmen's r = -0.145, P < 0.001).After adjusting for age, gender, risk factors for coronary artery disease, GFR and hsCRP, serum cystatin C ≥ 0.97 mg/L remained independently associated with poor collateralization (OR 2.374, 95% CI 1.660 ~ 3.396, P < 0.001).The diagnostic value of cystatin C levels for detecting poor coronary collateralization persisted regardless of age, gender, presence or absence of diabetes, hypertension or renal dysfunction.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People's Republic of China.

ABSTRACT

Objective: We investigated whether and to what extent cystatin C was associated with angiographic coronary collateralization in patients with stable coronary artery disease and chronic total occlusion.

Methods: Serum levels of cystatin C and high-sensitive C-reactive protein (hsCRP) and glomerular filtration rate (GFR) were determined in 866 patients with stable angina and angiographic total occlusion of at least one major coronary artery. The degree of collaterals supplying the distal aspect of a total occlusion from the contra-lateral vessel was graded as poor (Rentrop score of 0 or 1) or good coronary collateralization (Rentrop score of 2 or 3).

Results: In total, serum cystatin C was higher in patients with poor collateralization than in those with good collateralization (1.08 ± 0.32 mg/L vs. 0.90 ± 0.34 mg/L, P < 0.001), and correlated inversely with Rentrop score (adjusted Spearmen's r = -0.145, P < 0.001). The prevalence of poor coronary collateralization increased stepwise with increasing cystatin C quartiles (P for trend < 0.001). After adjusting for age, gender, risk factors for coronary artery disease, GFR and hsCRP, serum cystatin C ≥ 0.97 mg/L remained independently associated with poor collateralization (OR 2.374, 95% CI 1.660 ~ 3.396, P < 0.001). The diagnostic value of cystatin C levels for detecting poor coronary collateralization persisted regardless of age, gender, presence or absence of diabetes, hypertension or renal dysfunction.

Conclusions: Serum cystatin C reflects angiographic coronary collateralization in patients with stable coronary artery disease, and cystatin C ≥ 0.97 mg/L indicates a great risk of poor coronary collaterals.

No MeSH data available.


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Flowchart of patient enrollment.
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pone.0137253.g001: Flowchart of patient enrollment.

Mentions: Initially, we screened a total of 1092 consecutive patients with stable angina and chronic total occlusion (> 3 months) of at least one major epicardial coronary artery between March 2009 and February 2015 from the database of Advanced Glycation Endproducts and Development of CAD Program (AGENDA, S1 Document) in Rui Jin Hospital, Shanghai. This program included coronary artery disease patients with or without diabetes, aiming to investigate the mechanisms of atherosclerosis and elements affecting this process including advanced glycation endproducts in diabetes. Two-hundred and twenty six patients were excluded by the following exclusion criteria: (a) percutaneous coronary intervention within the prior 3 months; (b) previous coronary artery bypass grafting; (c) renal failure requiring hemodialysis; (d) chronic heart failure, pulmonary heart disease, malignant tumor or immune system disorders; (e) type 1 diabetes; and (f) unavailability of cystatin C data. Finally, 866 patients fit the inclusion criteria and composed the study cohort (Fig 1).


Serum Cystatin C Reflects Angiographic Coronary Collateralization in Stable Coronary Artery Disease Patients with Chronic Total Occlusion.

Shen Y, Ding FH, Zhang RY, Zhang Q, Lu L, Shen WF - PLoS ONE (2015)

Flowchart of patient enrollment.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4581619&req=5

pone.0137253.g001: Flowchart of patient enrollment.
Mentions: Initially, we screened a total of 1092 consecutive patients with stable angina and chronic total occlusion (> 3 months) of at least one major epicardial coronary artery between March 2009 and February 2015 from the database of Advanced Glycation Endproducts and Development of CAD Program (AGENDA, S1 Document) in Rui Jin Hospital, Shanghai. This program included coronary artery disease patients with or without diabetes, aiming to investigate the mechanisms of atherosclerosis and elements affecting this process including advanced glycation endproducts in diabetes. Two-hundred and twenty six patients were excluded by the following exclusion criteria: (a) percutaneous coronary intervention within the prior 3 months; (b) previous coronary artery bypass grafting; (c) renal failure requiring hemodialysis; (d) chronic heart failure, pulmonary heart disease, malignant tumor or immune system disorders; (e) type 1 diabetes; and (f) unavailability of cystatin C data. Finally, 866 patients fit the inclusion criteria and composed the study cohort (Fig 1).

Bottom Line: In total, serum cystatin C was higher in patients with poor collateralization than in those with good collateralization (1.08 ± 0.32 mg/L vs. 0.90 ± 0.34 mg/L, P < 0.001), and correlated inversely with Rentrop score (adjusted Spearmen's r = -0.145, P < 0.001).After adjusting for age, gender, risk factors for coronary artery disease, GFR and hsCRP, serum cystatin C ≥ 0.97 mg/L remained independently associated with poor collateralization (OR 2.374, 95% CI 1.660 ~ 3.396, P < 0.001).The diagnostic value of cystatin C levels for detecting poor coronary collateralization persisted regardless of age, gender, presence or absence of diabetes, hypertension or renal dysfunction.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People's Republic of China.

ABSTRACT

Objective: We investigated whether and to what extent cystatin C was associated with angiographic coronary collateralization in patients with stable coronary artery disease and chronic total occlusion.

Methods: Serum levels of cystatin C and high-sensitive C-reactive protein (hsCRP) and glomerular filtration rate (GFR) were determined in 866 patients with stable angina and angiographic total occlusion of at least one major coronary artery. The degree of collaterals supplying the distal aspect of a total occlusion from the contra-lateral vessel was graded as poor (Rentrop score of 0 or 1) or good coronary collateralization (Rentrop score of 2 or 3).

Results: In total, serum cystatin C was higher in patients with poor collateralization than in those with good collateralization (1.08 ± 0.32 mg/L vs. 0.90 ± 0.34 mg/L, P < 0.001), and correlated inversely with Rentrop score (adjusted Spearmen's r = -0.145, P < 0.001). The prevalence of poor coronary collateralization increased stepwise with increasing cystatin C quartiles (P for trend < 0.001). After adjusting for age, gender, risk factors for coronary artery disease, GFR and hsCRP, serum cystatin C ≥ 0.97 mg/L remained independently associated with poor collateralization (OR 2.374, 95% CI 1.660 ~ 3.396, P < 0.001). The diagnostic value of cystatin C levels for detecting poor coronary collateralization persisted regardless of age, gender, presence or absence of diabetes, hypertension or renal dysfunction.

Conclusions: Serum cystatin C reflects angiographic coronary collateralization in patients with stable coronary artery disease, and cystatin C ≥ 0.97 mg/L indicates a great risk of poor coronary collaterals.

No MeSH data available.


Related in: MedlinePlus