Serum cystatin C is associated with carotid atherosclerosis in patients with acute ischemic stroke
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ORIGINAL ARTICLE
Serum cystatin C is associated with carotid atherosclerosis in patients with acute ischemic stroke Jing Ren 1 & Xiaoyu Dong 1 & Jianfei Nao 1 Received: 22 February 2019 / Accepted: 28 March 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Background Accumulating studies have shown that cystatin C may play important roles in the pathogenesis of arteriosclerosis. However, the association between serum cystatin C and the characteristics of carotid plaques has not been elucidated. Furthermore, the diagnostic value of serum cystatin C in carotid stenosis has not been studied. Methods Serum cystatin C in 156 patients with acute ischemic stroke (AIS) in the carotid artery was measured by ELISA. Intima-media thickness (IMT), stenosis of the symptomatic common carotid artery (CCA), extra/intracranial internal carotid artery (ICA) stenosis, and plaque characteristics were measured and recorded. Receiver operating characteristic (ROC) curves were used to assess the diagnostic value of serum cystatin C in carotid stenosis. Results One hundred fifty-six patients were divided into two groups based on their cystatin C levels. The degree of arteriosclerosis, the severity of plaques, and stenosis of the symptomatic CCA were significantly higher in the patients with high cystatin C levels. In addition, the rate of unstable plaques was significantly higher in those with high cystatin C. Serum cystatin C levels of 1.075 and 1.125 mg/L had diagnostic value in distinguishing stenosis of CCA and extracranial ICA, respectively. Conclusions Higher cystatin C levels were strongly correlated with symptomatic CCA stenosis and the rate of unstable plaques. Analysis of cystatin C levels may be useful for the identification of CCA stenosis and extracranial ICA in patients with AIS. Keywords Cystatin C carotid arteriosclerosis . Carotid stenosis . Carotid plaque . Acute ischemic stroke
Introduction Stroke is a serious disease that endangers human health, and it has become the second leading cause of death in the world. Ischemic stroke (IS) is also one of the leading causes of disability and death in China [1]. Among the numerous factors affecting the onset of IS, carotid atherosclerosis is undoubtedly one of the most important and dangerous. Carotid atherosclerosis causes ischemic stroke through (1) intracranial arterial embolisms caused by plaque shedding, and (2) hypoperfusion of cerebral blood flow at the distal end of the stenosis. Jander et al. reported that 30% of ischemic strokes were caused by carotid artery lesions and were related to the stability of atherosclerotic plaques [2]. Goldstein et al. found that
* Jianfei Nao [email protected] 1
Department of Neurology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang 110004, Liaoning, People’s Republic of China
for every 10% increase in carotid stenosis, the risk of ischemic stroke increased by 26% [3]. Atherosclerotic plaques are formed by deep steatosis of the tunica intima and cholesterol deposition. Hyperte
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