The Prognostic Significance Of Cystatin C, Hcy And Hs-CRP In Patients With Vulnerable Plaque

Background: Acute coronary syndrome is associated with vulnerable plaque. Inflammation is the reason of the vulnerable plaque. And imbalance of protease and protease inhibitor levels plays an important role in the stability of the atherosclerotic plaque. As a protease inhibitor, the change of the Cystatin C levels in the plasma of ACS patients could reflect the stability of plaque. Hs-CRP is a marker of the systemic or local inflammation. It is very close with the degree of the atherosclerotic severity. Hyperhomocysteinemia, as an isolated dangerous factor of coronary heart disease, is prognostic for the stability of plaque.Objective: To explore the relation between the biochemical indexes in ACS patients, including Cystatin C, Hcy and Hs-CRP, and the stability of plaque.Methods: Serum Cystatin C, Hs-CRP and Hcy were detected synchronously in unstable angina (UAP), acute myocardial infarction (AMI) groups (onset<48hours) and controls.Results: Hs-CRP and Hcy in UAP and AMI groups both were higher than controls(P<0.05). And that of AMI group was also higher than UAP group(P<0.05). Cystatin C in UAP group was higher than controls(P<0.05), but that of AMI group was lower than controls(P<0.05). Univariate analysis showed that Hcy was positively associated with Hs-CRP(r=0.61, P<0.01). In UAP group, Cystatin C was positively associated with Hcy, Hs-CRP(r=0.22, 0.36, respectively, P < 0.01), however, there was no associated in AMI group(r=-0.04, 0.12, P=0.77,0.43, respectively). Conclusions: Hcy is positively associated with Hs-CRP. They both increase with the progress of atherosclerotic plaque. It is helpful todiagnosis,therapy and prognosis of CHD by detecting Hcy and Hs-CRP associatedly. To some degree, the change of Cystatin C levels could also reflect the stability of atherosclerotic plaque.