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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.


Related in: MedlinePlus

Receiver operating characteristic curves of predicted probabilities derived from regression models for detecting poor collateralization.Model 1 includes variables of age, gender, body mass index, traditional risk factors for coronary artery disease (diabetes, hypertension, dyslipidemia and smoke), multi-vessel disease, GFR and serum level of high sensitive C reactive protein. Model 2 includes variables in model 1 and serum cystatin C ≥ 0.97 mg/L.
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pone.0137253.g003: Receiver operating characteristic curves of predicted probabilities derived from regression models for detecting poor collateralization.Model 1 includes variables of age, gender, body mass index, traditional risk factors for coronary artery disease (diabetes, hypertension, dyslipidemia and smoke), multi-vessel disease, GFR and serum level of high sensitive C reactive protein. Model 2 includes variables in model 1 and serum cystatin C ≥ 0.97 mg/L.

Mentions: Multivariate logistic regression analysis revealed that age, gender, traditional risk factors for coronary artery disease, GFR and serum level of hsCRP were determinants for poor coronary collateralization (model 1). After adjustment for these variables, 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) (model 2) (Table 3). The calibrations of both models were good (P = 0.480 and P = 0.791, respectively). Compared with model 1, the addition of serum cystatin C (≥ 0.97 mg/L) in model 2 significantly improved the goodness-of-fit and predictive performance with an increase of Nagelkerke R2 of 7.3% (P < 0.001) and C statistic of 0.039 (95% CI 0.020 ~ 0.059, P < 0.001) (Fig 3) and a NRI and IDI of 10.5% (95% CI 4.6% ~ 16.4%, P < 0.001) and 5.9% (95% CI 4.3% ~ 7.5%, P < 0.001), respectively.


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)

Receiver operating characteristic curves of predicted probabilities derived from regression models for detecting poor collateralization.Model 1 includes variables of age, gender, body mass index, traditional risk factors for coronary artery disease (diabetes, hypertension, dyslipidemia and smoke), multi-vessel disease, GFR and serum level of high sensitive C reactive protein. Model 2 includes variables in model 1 and serum cystatin C ≥ 0.97 mg/L.
© Copyright Policy
Related In: Results  -  Collection

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

pone.0137253.g003: Receiver operating characteristic curves of predicted probabilities derived from regression models for detecting poor collateralization.Model 1 includes variables of age, gender, body mass index, traditional risk factors for coronary artery disease (diabetes, hypertension, dyslipidemia and smoke), multi-vessel disease, GFR and serum level of high sensitive C reactive protein. Model 2 includes variables in model 1 and serum cystatin C ≥ 0.97 mg/L.
Mentions: Multivariate logistic regression analysis revealed that age, gender, traditional risk factors for coronary artery disease, GFR and serum level of hsCRP were determinants for poor coronary collateralization (model 1). After adjustment for these variables, 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) (model 2) (Table 3). The calibrations of both models were good (P = 0.480 and P = 0.791, respectively). Compared with model 1, the addition of serum cystatin C (≥ 0.97 mg/L) in model 2 significantly improved the goodness-of-fit and predictive performance with an increase of Nagelkerke R2 of 7.3% (P < 0.001) and C statistic of 0.039 (95% CI 0.020 ~ 0.059, P < 0.001) (Fig 3) and a NRI and IDI of 10.5% (95% CI 4.6% ~ 16.4%, P < 0.001) and 5.9% (95% CI 4.3% ~ 7.5%, P < 0.001), respectively.

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