Correlation Analysis and Diagnostic Value of Serum Homocysteine, Cystatin C and Uric Acid Levels with the Severity of Coronary Artery Stenosis in Patients with Coronary Heart Disease

Abstract

Yang Gao,1,* Yuguang Guo,2,* Wenjun Hao,1 Jin Meng,1 Zhilin Miao,1 Aijie Hou,1 Bo Luan1 1Department of Cardiology, the People’s Hospital of Liaoning Province, Shenyang, People’s Republic of China; 2Department of Clinical Laboratory, the People’s Hospital of Liaoning Province, Shenyang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Bo Luan, Department of Cardiology, the People’s Hospital of Liaoning Province, No. 33, Wenyi Road, Shenhe District, Shenyang, Liaoning Province, 110016, People’s Republic of China, Email [email protected]: Coronary angiography (CAG) is an invasive examination with high risks and costs and various complications may occur. It is necessary to find a diagnostic method, non-invasiveness, inexpensive with low risk. This study aims to analyze the correlation between the levels of serum homocysteine (Hcy), cystatin C (Cys C) and uric acid (UA) and Gensini score in patients with coronary heart disease (CHD) and assess their diagnostic value for CHD.Methods: A retrospective analysis was conducted on 1412 patients underwent CAG from October 2019 to December 2021, and we conducted this study from January to July 2022. A total of 765 patients with CHD confirmed by CAG were selected as the research group, while 647 patients revealed as non-obstructive stenosis by CAG as the control group. The serum Hcy, Cys C and UA levels were detected and the correlation between Gensini score and variables was analyzed. The receiver-operating characteristic (ROC) curve was performed to assess the diagnostic value of the Hcy, Cys C and UA for CHD.Results: The serum Hcy, Cys C and UA levels in the research group were higher as compared with the control group (p< 0.05). Spearman correlation and multivariate linear regression analysis showed that there was a significantly positive correlation between Gensini score and serum Hcy, Cys C and UA levels (p< 0.05). The ROC curve analysis presented the combined Hcy and Cys C with UA having the highest specificity of diagnostic value for CHD (area under the curve (AUC)=0.768, 95% CI 0.706– 0.823, specificity = 72.34%, sensitivity = 67.88%, Youden Index = 0.4022).Conclusion: The serum Hcy, Cys C and UA levels in patients with CHD were significantly increased, positive correlation with Gensini score. The combined Hcy and Cys C with UA could be used to assess the severity of coronary artery stenosis and provide predictive and early intervention treatment values for CHD and a new way of diagnosing CHD, which is cheap, safe, effective and deserving of clinical application.Keywords: serum homocysteine, cystatin C, uric acid, gensini score, correlation analysis, diagnostic value

Keywords

• serum homocysteine
• cystatin c
• uric acid
• gensini score
• correlation analysis
• diagnostic value.