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Relationship of cystatin C with coronary artery disease and its severity

Doganer, Yusuf C.a; Aydogan, Umitb; Aydogdu, Aydoganc; Aparci, Mustafah; Akbulut, Halilb; Nerkiz, Polatb; Turker, Turkerd; Cayci, Tuncere; Barcin, Cemf; Saglam, Kenang

doi: 10.1097/MCA.0b013e32835b6761
Diagnostic Methods

Objective Cystatin C, which is an endogenous marker for renal function, is reported to be a novel marker for coronary atherosclerosis. In this study, we aimed to evaluate its role in determining the presence and also the severity of coronary atherosclerosis in patients with coronary artery disease (CAD).

Materials and methods Eighty-eight patients who underwent elective coronary angiography were enrolled in the study. Patients with heart failure, renal failure, diabetes, and thyroid disease were excluded from the study. The study population was divided into three groups: individuals with normal coronary arteries, patients with critical CAD, and patients with noncritical CAD. We also analyzed the relationship of cystatin C levels with the presence and the severity of CAD and the number of vessels involved.

Results The mean age of the study group was 51.73±9.21 years, and the majority were men (n=71, 80.7%). Cystatin C levels were significantly lower in patients with CAD (1334.86±93.45 vs. 836.49±411.29, P<0.001). It was significantly lower in patients with critical CAD compared with those with noncritical CAD and normal individuals (656.60±346.35, 1016.38±396.54, and 1334.86±393.45, P<0.001, respectively). Serum levels of cystatin C according to the numbers of coronary vessels such as none, single-vessel, two-vessel, three-vessel, and four-vessel disease were as follows: 1334.86±393.45, 801.67±418.70, 993.90±457.34, 744.09±354.53, and 682.30±294.43, respectively.

Conclusion Lower cystatin C levels may be associated with increased severity of CAD in clinically stable patients, whereas higher levels may indicate the presence of any vulnerable plaque. It may also guide the diagnostic and therapeutic options for the clinical scene on the presentation.

aDepartment of Family Medicine, Turkish Military Academy Primary Care Center

Departments of bFamily Medicine




fCardiology, and

gInternal Medicine, Gulhane Military Medical Academy

hDepartment of Cardiology, Etimesgut Military Hospital, Ankara, Turkey

Correspondence to Mustafa Aparci, MD, Department of Cardiology, Etimesgut Military Hospital, Etimesgut 06790, Ankara, Turkey Tel: +90 505 3947131; fax: +90 312 2444977; e-mail:

Received August 5, 2012

Accepted October 4, 2012

© 2013 Lippincott Williams & Wilkins, Inc.