Key result
Elevated cystatin C linked to ~6.6-fold higher odds of severe peripheral arterial disease.
Why the study?
Cathepsin S promotes inflammatory pathways while Cystatin C inhibits it, leading to Cystatin C being proposed as a biomarker of progression in peripheral arterial disease.
Are elevated serum Cystatin C and decreased Cathepsin S/Cystatin C ratio associated with severe peripheral arterial disease and polyvascular involvement?
Observational (n=90)
No
Are elevated serum Cystatin C and decreased Cathepsin S/Cystatin C ratio associated with severe peripheral arterial disease and polyvascular involvement?
High serum Cystatin C and low Cathepsin S/Cystatin C ratios may serve as biomarkers for severe peripheral arterial disease and polyvascular atherosclerotic involvement.
Elevated cystatin C may flag severe PAD; hypothesis-generating for biomarker utility and requires prospective validation.
Peripheral arterial disease (PAD) is frequently associated with atherosclerotic manifestations of the carotids and coronaries. Polyvascular involvement and low ankle−brachial index predict major cardiovascular events and high mortality. Cathepsin S (Cat S) promotes the inflammatory pathways of the arterial wall, while Cystatin C (Cys C) functions as its inhibitor; therefore, Cys C was proposed to be a biomarker of progression in PAD. In a single-center observational study, we investigated the correlations of serum Cys C and Cat S/Cys C ratio in a group of 90 PAD patients, predominantly with polyvascular involvement. Cys C and Cat S/Cys C were associated with ankle−brachial index (ABI) scores <0.4 in univariate and multiple regression models. Furthermore, both markers correlated positively with the plasma Von Willebrand Factor Antigen (VWF: Ag) and Von Willebrand Factor collagen-binding activity (VWF: CB). In addition, Cat S/Cys C was significantly decreased, whereas Cys C increased in subjects with three-bed atherosclerotic involvement. According to our results, high serum Cys C and low Cat S/Cys C ratios may indicate severe peripheral arterial disease and polyvascular atherosclerotic involvement.
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Nagy et al. (2022) conducted an observational in Peripheral arterial disease (n=90). Elevated serum Cystatin C (upper tertile) vs. Lower tertiles of Cystatin C was evaluated on Severe peripheral arterial disease (Ankle-Brachial Index ≤ 0.4) (OR 6.57, 95% CI 2.10-20.47, p=0.016). Elevated serum Cystatin C in the upper tertile was independently associated with severe peripheral arterial disease (ABI ≤ 0.4) with an odds ratio of 6.57.
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