Serum cystatin C and neutrophil gelatinase-associated lipocalin in predicting the severity of coronary artery disease in diabetic patients

Abstract

Objective:Cystatin C and neutrophil gelatinase-associated lipocalin (NGAL) are biomarkers of renal functions. We evaluated their roles in predicting the severity of coronary artery disease (CAD).Methods:Fifty-two consecutive type 2 diabetic patients (32 males, 65.7±8.6 years) who underwent coronary angiography (CAG) for stable CAD were included in this single-center, prospective, cross-sectional study. Patients with an estimated glomerular filtration rate <60 mL/min/1.73 m2 and with a history of by-pass surgery and/or coronary stent implantation were excluded. The vessel score and Gensini score were calculated to assess the presence and severity of CAD. Mann–Whitney U test, Spearman test, and multiple linear regression analysis were used for the main statistical analyses.Results:Serum cystatin C levels were higher in patients with multivessel disease than in those with single vessel disease [1260 ng/mL (953–1640) vs. 977 ng/mL (599–1114), p=0.017]. According to the median Gensini score, the higher score group also had higher cystatin C levels than the lower score group [1114 ng/mL (948–1567) vs. 929 ng/mL (569–1156), p=0.009]. However, serum NGAL levels were similar between these subgroups. There was a positive correlation between cystatin C and Gensini score (r=0.334, p=0.016). Multiple linear regression analysis revealed serum cystatin C as an independent predictor of the Gensini score (b=0.360, t=2.311, p=0.026). These results may aid in defining cystatin C as a surrogate marker of the extent of CAD in further clinical trials.Conclusion:Serum Cystatin C, but not NGAL levels, could predict the severity of CAD in diabetic patients.

Clinical Role, Diagnostic and Prognostic Value of Human Cystatin C Through the Body

“…Serum Cystatin C, but not neutrophil gelatinase-associated lipocalin levels, could predict the severity of coronary artery disease in di-abetic patients 55 . It reflects angiographic coronary collateralization in patients with stable coronary artery disease, and 0.97 mg/L of Cystatin C indicates a great risk of poor coronary collaterals 59 .…”

“…Association between high levels of Cystatin C and increased risk of future development of metabolic syndrome was found 10 . In metabolic syndrome previous studies have found, Cystatin C has been found to be associated with severity of coronary artery disease 55 . Cystatin C levels progressively increased in association with the number of metabolic syndrome component disorders coexistent within an individual 47 .…”

Non-HDL-C vs. LDL-C in Predicting the Severity of Coronary Atherosclerosis

“…Okyay and colleagues conducted a study in 52 consecutive type 2 diabetic patients who underwent coronary angiography for stable CAD. Serum Cystatin C, but not neutrophil gelatinase-associated lipocalin levels, could predict the severity of CAD in diabetic patients [20].…”

The relationship between soluble lymphocyte activation gene-3 and coronary artery disease

“…For example, soluble suppression of tumorigenicity 2 was associated with all-cause mortality in patients with the chronic coronary syndrome (CCS) ( 7 ). Cystatin C may also be related to the severity of CAD in patients with diabetes mellitus ( 8 ). Lastly, red blood cell distribution width is independently associated with myocardial scar burden and left ventricular function in patients with CAD ( 9 ).…”

“…Thus, the association between inflammation and CAD status is well established. Multiple studies have identified circulating biomarkers in peripheral blood for diagnosis, evaluation, or prognosis of CAD (7)(8)(9)(10). For example, soluble suppression of tumorigenicity 2 was associated with all-cause mortality in patients with the chronic coronary syndrome (CCS) (7).…”