title: Cystatin C associates with the prediction of in-stent restenosis among patients receiving stent implantation: results of the 1-year follow-up.
abstract: BACKGROUND
  For a long time, serum cystatin C (Cys C) was only considered an indicator of renal function besides creatinine. Recently, it has been found that it is also a good biomarker showing the oxidative status of the human body. We hypothesized that serum Cys C levels are associated with in-stent restenosis (ISR) among patients receiving stent implantation.
  
  
  METHODS
  Here, we enrolled 145 (men, 110; mean age, 59.6±11.1) consecutive patients admitted to the Fourth Affiliated Hospital of Harbin Medical University for stent implantation. At 11.2±3.2 months after stent implantation, all of the patients were administered coronary angiography to evaluate ISR. The serum levels of total bilirubin (TB), high-sensitive C-reactive protein (hs-CRP), and Cys C were obtained to determine the relationship of ISR with these oxidative-related biomarkers.
  
  
  RESULTS
  A total of 163 stents were studied; patients experiencing ISR had considerably higher levels of serum hs-CRP and Cys C and lower levels of TB compared with patients without ISR (TB, 13.7±3.5 vs. 11.8±4.0 μmol/l, P=0.007; hs-CRP, 11.8±6.0 vs. 5.9±6.4 μmol/l, P=0.001; Cys C, 1.68±0.85 vs. 0.94±0.24 mg/l, P<0.001). Furthermore, the Cox proportional hazard model showed that serum TB [odds ratio (OR)=2.42, 95% confidence interval (CI), 2.21-2.68, P=0.028], hs-CRP (OR=2.89, 95% CI, 2.76-3.02, P=0.003), and Cys C (OR=80.46, 95% CI, 11.10-2977.60, P<0.001) are all independent predictors of ISR.
  
  
  CONCLUSIONS
  Cys C, together with TB and hs-CRP, is an independent risk factor associated with ISR.
authors.affiliation: Department of Cardiology, 4th Affiliated Hospital of Harbin Medical University, 37 Yiyuan St., Harbin, China.
authors.forename: Chunyu
authors.initials: C
authors.lastname: Zhao
authors.forename: Lanshu
authors.initials: L
authors.lastname: Yang
authors.forename: Lili
authors.initials: L
authors.lastname: Mao
authors.forename: Lihua
authors.initials: L
authors.lastname: Zhong
authors.forename: Xueqi
authors.initials: X
authors.lastname: Li
authors.forename: Shipeng
authors.initials: S
authors.lastname: Wei
mesh_terms: D000368:Aged; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002681:China; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology*; D055316:Cystatin C / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000295:instrumentation*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C; D002097:C-Reactive Protein; D001663:Bilirubin