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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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Prevalence of poor collateralization in patients across quartiles of serum cystatin C.
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pone.0137253.g002: Prevalence of poor collateralization in patients across quartiles of serum cystatin C.

Mentions: Serum cystatin C was significantly 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 before (Spearmen’s r = -0.263, P < 0.001) and after (Spearmen’s r = -0.145, P < 0.001) adjusting for gender, age, BMI, traditional risk factors for coronary artery disease (including smoking, hypertension, hyperlipidemia and diabetes), multi-vessel disease, GFR and serum level of hsCRP. In addition, the prevalence of poor coronary collaterals increased stepwise from the lowest quartile (< 0.76 mg/L) to the highest quartile of serum cystatin C (≥ 1.11 mg/L) (P for trend < 0.001) (Fig 2). Odds ratio for poor collateralization increased to 6.300 (95% confidence interval [CI] 4.065 ~ 9.764) in the highest compared with those in the lowest quartile of cystatin C level (P < 0.001). These associations remained significant after adjusting for multiple variables (OR: 7.021, 95% CI 4.261 ~ 11.570, P < 0.001) (Table 2).


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)

Prevalence of poor collateralization in patients across quartiles of serum cystatin C.
© Copyright Policy
Related In: Results  -  Collection

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

pone.0137253.g002: Prevalence of poor collateralization in patients across quartiles of serum cystatin C.
Mentions: Serum cystatin C was significantly 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 before (Spearmen’s r = -0.263, P < 0.001) and after (Spearmen’s r = -0.145, P < 0.001) adjusting for gender, age, BMI, traditional risk factors for coronary artery disease (including smoking, hypertension, hyperlipidemia and diabetes), multi-vessel disease, GFR and serum level of hsCRP. In addition, the prevalence of poor coronary collaterals increased stepwise from the lowest quartile (< 0.76 mg/L) to the highest quartile of serum cystatin C (≥ 1.11 mg/L) (P for trend < 0.001) (Fig 2). Odds ratio for poor collateralization increased to 6.300 (95% confidence interval [CI] 4.065 ~ 9.764) in the highest compared with those in the lowest quartile of cystatin C level (P < 0.001). These associations remained significant after adjusting for multiple variables (OR: 7.021, 95% CI 4.261 ~ 11.570, P < 0.001) (Table 2).

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