title: Cystatin C Is Associated with the Extent and Characteristics of Coronary Atherosclerosis in Patients with Preserved Renal Function.
abstract: Cystatin C (CysC), an endogenous inhibitor of cysteine proteases and a sensitive and accurate marker of renal function, is associated with the severity of coronary atherosclerosis assessed by angiography and future cardiovascular events according to previous studies. We aimed to evaluate the association between CysC levels and coronary plaque volume, composition and phenotype assessed by intravascular ultrasound and intravascular ultrasound-derived virtual histology in patients with preserved renal function. Forty-four patients with angiographically documented coronary artery disease and complete intravascular imaging were included in the study. Patients were categorized into tertiles by CysC levels. Subjects in the high CysC tertile had significantly higher mean plaque burden (48.0 % ± 6.9 vs. 42.8 % ± 7.4, P = 0.029), lower mean lumen area (8.1 mm2 ± 1.7 vs. 9.9 mm2 ± 3.1, P = 0.044) and a higher number of 5-mm vessel segments with minimum lumen area < 4 mm2 (17.9 ± 18.9 vs. 6.8 ± 11.7, P = 0.021) compared to patients in the lower tertiles. In addition, CysC levels demonstrated significant positive correlation with the mean plaque burden (r = 0.35, P = 0.021). Neither relative, nor absolute plaque components differed significantly according to CysC tertiles. The Liverpool Active Plaque Score was significantly higher in the high CysC tertile patients (0.91 ± 1.0 vs. 0.18 ± 0.92, P = 0.02). In conclusion, our study demonstrated a significant association of increased CysC levels with more advanced coronary artery disease and higher risk plaque phenotype in patients with preserved renal function.
authors.affiliation: 2nd Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic.
authors.forename: A
authors.initials: A
authors.lastname: Král
authors.affiliation: 2nd Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic.
authors.forename: T
authors.initials: T
authors.lastname: Kovárník
authors.affiliation: Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic.
authors.forename: Z
authors.initials: Z
authors.lastname: Vaníčková
authors.affiliation: 2nd Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic.
authors.forename: H
authors.initials: H
authors.lastname: Skalická
authors.affiliation: 2nd Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic.
authors.forename: J
authors.initials: J
authors.lastname: Horák
authors.affiliation: 2nd Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic.
authors.forename: K
authors.initials: K
authors.lastname: Bayerová
authors.affiliation: Iowa Institute for Biomedical Imaging, Department of Electrical & Computer Engineering, The University of Iowa, Iowa City, IA, USA.
authors.forename: Z
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Iowa Institute for Biomedical Imaging, Department of Electrical & Computer Engineering, The University of Iowa, Iowa City, IA, USA.
authors.forename: A
authors.initials: A
authors.lastname: Wahle
authors.affiliation: Iowa Institute for Biomedical Imaging, Department of Electrical & Computer Engineering, The University of Iowa, Iowa City, IA, USA.
authors.forename: L
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Cardiology Department of Homolka Hospital, Prague, Czech Republic.
authors.forename: K
authors.initials: K
authors.lastname: Kopřiva
authors.affiliation: Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic.
authors.forename: H
authors.initials: H
authors.lastname: Benáková
authors.affiliation: Iowa Institute for Biomedical Imaging, Department of Electrical & Computer Engineering, The University of Iowa, Iowa City, IA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Sonka
authors.affiliation: 2nd Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic.
authors.forename: A
authors.initials: A
authors.lastname: Linhart
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D003324:Coronary Artery Disease / Q000378:metabolism* / Q000503:physiopathology*; D055316:Cystatin C / Q000378:metabolism*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007249:Inflammation / Q000473:pathology; D007668:Kidney / Q000378:metabolism* / Q000503:physiopathology*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D058226:Plaque, Atherosclerotic / Q000378:metabolism / Q000503:physiopathology; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D019010:Vascular Cell Adhesion Molecule-1 / Q000378:metabolism
chemical_list: D015415:Biomarkers; D055316:Cystatin C; D014409:Tumor Necrosis Factor-alpha; D019010:Vascular Cell Adhesion Molecule-1