Abstract
Cystatin C, cathepsin S, and IL-1 are three important biomarkers of atherosclerosis. Previous studies emphasized the relationship between individual biomarkers in coronary artery disease (CAD) patients and severity of atherosclerostic lesions of the coronary arteries, while combined cystatin C, cathepsin S, and IL-1 have not been reported for clinical classification of CAD. We aimed to establish a link between cystatin C, cathepsin S, IL-1 and CAD in this cohort study. Totally 112 subjects were enrolled and divided into the stable angina pectoris group, the unstable angina pectoris group and the acute myocardial infarction (AMI) groups, and 50 healthy adults served as controls. The levels of the three biomarkers were detected by ELISA. The results showed that serum level of cystatin C (mg/L) was higher in CAD patients compared with those in the healthy controls (AMIvs. unstable angina pectoris vs. stable angina pectoris vs. controls: 1.27±0.18 vs. 1.09±0.19 vs. 0.91±0.05 vs. 0.78±0.07, all P<0.01). Cathepsin S (ng/mL) was also significantly different among the groups (AMI vs. unstable angina pectoris vs. stable angina pectoris vs. controls: 67.30±8.36 vs. 56.90±7.16 vs. 49.8±2.72 vs. 67.30±8.36, all P<0.01). IL-1 (pg/mL) was significantly different among the groups as well (AMIvs. unstable angina pectoris vs. stable angina pectoris vs. controls: 2.96±0.57 vs. 2.46±0.24 vs. 2.28±0.09 vs. 2.02±0.13, all P<0.01). Spearman's correlation test revealed positive correlation between cystatin C, cathepsin S, IL-1 and Gensini score (r=0.451, 0.491, 0.397, respectively). It is suggested that simultaneous detection of cystatin C, cathepsin S, and IL-1 in serum may be useful in clinical classification and assessment of severity of CAD.
Highlights
Coronary artery disease (CAD) is a prevalent disease that poses a serious threat to public health
Among the 162 participants, significant differences were found in age, LDC-C, diastolic blood pressure (DBP), systolic blood pressure (SBP), White blood cell (WBC), ESR, history of drinking, smoking and diabetes (P < 0.05)
We aimed to assess the prognostic value of combined cathepsin S, cystatin C and IL-1b on differentiating clinical classification of CAD
Summary
Coronary artery disease (CAD) is a prevalent disease that poses a serious threat to public health. Detection and treatment significantly increase the chance of survival for CAD patients. Vascular intervention is the most direct and accurate method to diagnose and treat CAD and other atherosclerotic diseases, its clinical application is still limitated to early atherosclerosis, and it is hampered by its invasiveness, high cost, inconvenient continuous monitoring, and frequent follow-up visits. Vascular remodeling and extracellular matrix (ECM) degradation play important roles in the process[4,5], and vascular remodeling requires that the ECM be degraded by specific cathepsin cysteine protease[6]. Stimulated by inflammatory mediators, vascular smooth muscle cells secrete cathepsin cysteine proteases S (cathepsin S), whose elastolytic activity[7] accelerates destruction of arterial elastin. As a member of cysteine protease inhibitor super-families, cystatin C shows the highest inhibitory action on cathepsins S[8]
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