Abstract 19983: Elevated Levels of Serum Cystatin C Predict Early Stage of Coronary Atherosclerotic Plaque Detected by Multidetector Computed Tomography
Introduction: Chronic kidney disease is associated with increased risk of cardiovascular disease. Cystatin C, a novel measure of renal function, has been implicated as a prognostic marker in cardiovascular disease.
Hypothesis: We tested the hypothesis that cystatin C is associated with coronary atherosclerotic plaque detected by multidetector computed tomography (MDCT).
Methods: The study included participants who had measurements of cystatin C and 64-slice MDCT for suspected coronary artery disease. A total of 513 patients with an estimated glomerular filtration rate of ≥60ml/min per 1.73m2 (mean age 68+/-11 years, 61% male) and without significant coronary artery stenosis at MDCT were enrolled. Participants were categorized into quartiles of serum cystatin C at inception, with ≤0.91mg/L constituting the lowest quartile and ≥1.30mg/L constituting the highest. With coronary CT angiography, presence of calcified or noncalcified atherosclerotic plaque and significant stenosis(>50%) were separately assessed by two independent readers.
Results: Among the 513 participants, 269 (52%) had calcified plaque and 164(32%) had noncalcified plaque at MDCT. Compared with participants in the lowest cystatin C quartile(n=148), those in the highest quartile (n=123) were at increased risk of calcified coronary plaque(odds ratio[OR], 3.2; 95% CI, 2.3 to 6.1;p<0.001) and noncalcified coronary plaque(OR, 2.1; 95% CI, 1.2 to 3.8;p=0.01) in analyses adjusted for traditional cardiovascular risk factors. Both calcified and noncalcified atherosclerotic plaque increased significantly with each quartile of cystatin C. Serum creatinine was not associated with calcified or noncalcified atherosclerotic plaque in this group of patients with normal or mildly decreased renal function.
Conclusions: In conclusion, elevated levels of serum cystatin C are a potent predictor of preclinical coronary atherosclerotic plaque beyond classical risk factors in patients with normal or mildly decreased renal function.
- © 2010 by American Heart Association, Inc.