Correlation between serum cystatin C level and nonobstructive coronary artery disease

doi:10.3969/j.issn.1004-583X.2023.09.005

Abstract

Abstract:

Objective To investigate the correlation between serum cystatin C level and nonobstructive coronary artery disease. Methods A total of 331 elderly patients who underwent coronary angiography with suspected coronary artery disease in the Department of Cardiology, Baoding No.1 Central Hospital were enrolled between June 2021 and December 2021. They were divided into coronary normal group and nonobstructive coronary artery group according to the results of coronary angiography. Single-vessel, 2-vessel and 3-vessel lesions were classified according to the number of diseased coronary arteries and the Gensini score was calculated according to the results of coronary angiography. The general clinical data and biochemical indicators were compared between the two groups and multivariate Logistic regression analysis was used to identify the risk factors for nonobstructive coronary artery disease. Results There were no significant differences between the two groups in the body mass index (BMI), platelet count, fasting plasma glucose, low-density lipoprotein cholesterol (LDL-C), smoking and the family history of coronary artery disease ( $P$ >0.05). Age, sex constitution, proportion of hypertension, diabetes, and hyperlipidemia, and cystatin C levels were significantly higher in nonobstructive coronary artery group than those of coronary normal group ( $P$ <0.05 or <0.01). In nonobstructive coronary artery group, the proportion of single-vessel lesion was lower in patients with high cystatin C levels than those with low cystatin C levels (28.1% vs 46.7%, $P$ <0.05), but the proportion of 3-vessel lesion was significantly higher (37.5% vs 20.0%, $P$ <0.05). With the increase in cystatin C level, the Gensini score increased significantly, showing a positive correlation ( $r$ =0.525, $P$ <0.01). The multivariate Logistic regression analysis result showed that age, sex, hyperlipidemia, cystatin C were risk factors for nonobstructive coronary artery disease. Conclusion Cystatin C might serve as a significant prognostic marker for nonobstructive coronary artery disease.

Key words: nonobstructive coronary artery disease, cystatin C, coronary angiography

CLC Number:

R541.4

Li Hua, Chen Jianjun, Wei Jitao, Zhang Qi. Correlation between serum cystatin C level and nonobstructive coronary artery disease[J]. Clinical Focus, 2023, 38(9): 802-805.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2023.09.005

https://huicui.hebmu.edu.cn/EN/Y2023/V38/I9/802

Figures/Tables 4

Tab. 1 Comparison of general data between groups

项目	冠脉正常组( $n$ =207)	非阻塞性冠脉病变组( $n$ =124)	$t$ /χ²值	$P$ 值
年龄(岁, $bar{x} pm s$)	64.37±8.02	65.28±8.25	-3.212	0.034
男性[例(%)]	66(31.9)	57(46.0)	6.587	0.01
危险因素
BMI(kg/m², $bar{x} pm s$)	24.62±3.40	24.83±3.35	-0.536	0.592
吸烟[例(%)]	30(14.5)	26(21.0)	2.313	0.128
高血压[例(%)]	72(34.8)	64(51.6)	9.075	0.003
糖尿病[例(%)]	16(7.7)	21(16.9)	6.619	0.010
高血脂[例(%)]	19(9.2)	24(19.5)	7.270	0.007
冠心病家族史[例(%)]	9(4.3)	9(7.3)	1.277	0.258
血生化指标
血小板(×10⁹/L)	208.30±51.93	203.58±55.00	0.755	0.451
空腹血糖(mmol/L)	5.61±1.35	5.80±1.63	-1.018	0.309
TG(mmol/L)	1.89±0.82	2.02±0.88	-0.568	0.556
TC(mmol/L)	3.92±0.84	4.15±0.89	-0.604	0.435
LDL-C(mmol/L)	2.88±0.72	2.94±0.89	-0.610	0.542
胱抑素C(mg/L)	0.86±0.18	0.97±0.17	-5.507	<0.01

Tab. 1 Comparison of general data between groups

项目	冠脉正常组( $n$ =207)	非阻塞性冠脉病变组( $n$ =124)	$t$ /χ²值	$P$ 值
年龄(岁, $bar{x} pm s$)	64.37±8.02	65.28±8.25	-3.212	0.034
男性[例(%)]	66(31.9)	57(46.0)	6.587	0.01
危险因素
BMI(kg/m², $bar{x} pm s$)	24.62±3.40	24.83±3.35	-0.536	0.592
吸烟[例(%)]	30(14.5)	26(21.0)	2.313	0.128
高血压[例(%)]	72(34.8)	64(51.6)	9.075	0.003
糖尿病[例(%)]	16(7.7)	21(16.9)	6.619	0.010
高血脂[例(%)]	19(9.2)	24(19.5)	7.270	0.007
冠心病家族史[例(%)]	9(4.3)	9(7.3)	1.277	0.258
血生化指标
血小板(×10⁹/L)	208.30±51.93	203.58±55.00	0.755	0.451
空腹血糖(mmol/L)	5.61±1.35	5.80±1.63	-1.018	0.309
TG(mmol/L)	1.89±0.82	2.02±0.88	-0.568	0.556
TC(mmol/L)	3.92±0.84	4.15±0.89	-0.604	0.435
LDL-C(mmol/L)	2.88±0.72	2.94±0.89	-0.610	0.542
胱抑素C(mg/L)	0.86±0.18	0.97±0.17	-5.507	<0.01

Tab. 2 Comparison of cystatin C in different coronary artery lesions subgroups ($bar{x} pm s$, mg/L)

组别	例数	胱抑素C
单支	46	0.82±0.14
双支	42	0.93±0.16
三支	36	1.03±0.18
χ²值		12.304
$P$ 值		0.018

Tab. 2 Comparison of cystatin C in different coronary artery lesions subgroups ($bar{x} pm s$, mg/L)

组别	例数	胱抑素C
单支	46	0.82±0.14
双支	42	0.93±0.16
三支	36	1.03±0.18
χ²值		12.304
$P$ 值		0.018

Tab. 3 Comparison of cystatin C in subgroups of coronary artery disease with different causes ($bar{x} pm s$, mg/L)

组别	例数	胱抑素C
慢血流	4	0.88±0.13
扩张性病变	5	0.87±0.14
冠脉肌桥	13	0.84±0.14
χ²值		1.324
$P$ 值		0.326

Tab. 3 Comparison of cystatin C in subgroups of coronary artery disease with different causes ($bar{x} pm s$, mg/L)

组别	例数	胱抑素C
慢血流	4	0.88±0.13
扩张性病变	5	0.87±0.14
冠脉肌桥	13	0.84±0.14
χ²值		1.324
$P$ 值		0.326

Tab. 4 Multiple logistic regression analysis of nonobstructive coronary artery disease and clinical indicators

项目	回归系数	标准误	Wald χ²值	$P$ 值	$O R$ 值	95% $C I$
年龄	0.918	0.201	10.351	0.003	2.331	1.532~5.023
性别	0.951	0.234	11.155	0.001	2.587	1.481~4.591
高血压	0.386	0.198	2.108	0.147	1.472	0.847~2.480
糖尿病	0.749	0.165	3.754	0.053	2.115	0.991~4.514
高血脂	1.327	0.323	13.203	0.000	3.770	1.843~7.713
胱抑素C	1.939	0.421	5.575	0.018	6.953	1.390~34.773

Tab. 4 Multiple logistic regression analysis of nonobstructive coronary artery disease and clinical indicators

项目	回归系数	标准误	Wald χ²值	$P$ 值	$O R$ 值	95% $C I$
年龄	0.918	0.201	10.351	0.003	2.331	1.532~5.023
性别	0.951	0.234	11.155	0.001	2.587	1.481~4.591
高血压	0.386	0.198	2.108	0.147	1.472	0.847~2.480
糖尿病	0.749	0.165	3.754	0.053	2.115	0.991~4.514
高血脂	1.327	0.323	13.203	0.000	3.770	1.843~7.713
胱抑素C	1.939	0.421	5.575	0.018	6.953	1.390~34.773

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