Cystatin C combined with carotid artery plaque score improves predictability of significant coronary ar-tery disease in patients with chest pain
10.3969/j.issn.1006-5725.2017.11.012
- VernacularTitle:胱抑素C联合颈动脉斑块评分提高胸痛者严重冠心病的预测能力
- Author:
Xiaoyan WU
;
Fei MIAO
;
Qiushi WANG
;
Peng LIU
;
Hongchao WU
;
Yingfeng LIU
;
Yan. ZHANG
- Keywords:
Cystatin C;
Carotid artery plaque score;
Chest pain;
Significant coronary artery disease;
Receiver-operating characteristic curves
- From:
The Journal of Practical Medicine
2017;33(11):1765-1769
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the value of plasma level of cystatin C(Cyst-C)and carotid artery plaque score(PS)in predicting significant coronary artery disease(SCAD)in patients with chest pain. Methods A total of 192 patients with chest pain were involved retrospectively. According to the coronary angiography results ,the patients were divided into groups of SCAD (n = 128) and non-significant coronary artery disease (NSCAD , n = 64). Analyses were done to discuss the association of Cyst-C and PS with SCAD and the predictive value of Cyst-C and PS for SCAD. Results Logistic regression analysis demonstrated that Cyst-C and PS were independent predictors of SCAD. The odds ratios(OR)associated with the Cyst-C(each 1 mg/L)and PS(each 1 mm)for prediction of SCAD were 1.329 and 1.197,respectively. The areas under the receiver-operating characteristic curves(AUC)for the Cyst-C and the PS to predict the SCAD were 0.654 and 0.688,respectively. The combination of Cyst-C and PS increased the AUC to 0.742. The optimal cut-off value of Cyst-C was 0.95 mg/L and had a sensitivity of 72.3% for SCAD. Similarly,the optimal cut-off level of PS was 3mm which presented a sensitivity of 70.7%. A Cyst-C ≥ 0.95 mg/L and a PS ≥ 3 mm had negative predictive values of 46.3% and 48.3%,respectively,for SCAD. By combining Cyst-C with PS ,the sensitivity and negative predictive value increased to 83.6%and 62.5%, respectively. Conclusions Cyst-C and PS are both correlated with SCAD. They are independent predictive factors for SCAD in patients with chest pain. Combination of Cyst-C and PS can improve the predictability ,which may increase the reliability of screening SCAD before cardiac catheterization.
