Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2024; 12(18): 3461-3467
Published online Jun 26, 2024. doi: 10.12998/wjcc.v12.i18.3461
Serum cystatin C, monocyte/high-density lipoprotein-C ratio, and uric acid for the diagnosis of coronary heart disease and heart failure
Ming Li, Da-Hao Yuan, Zhi Yang, Teng-Xiang Lu, Xiao-Biao Zou
Ming Li, Da-Hao Yuan, Zhi Yang, Clinical Laboratory, Linquan County People's Hospital, Linquan 236400, Anhui Province, China
Teng-Xiang Lu, Hemodialysis Center, Linquan County People's Hospital, Linquan 236400, Anhui Province, China
Xiao-Biao Zou, Cardiovascular Medicine, Linquan Country People’s Hospital, Linquan 236400, Anhui Province, China
Author contributions: Li M and Yuan DH conceptualized this study; Yang Z and Yuan DH contributed to data collection; Zou XB and Lu TX drafted the initial manuscript and contributed to formal analysis; Li M provided guidance for this study and contributed to methodology and visualization together with Yang Z and Zou XB; Lu TX and Yang Z validated this study. All authors participated in this study and jointly reviewed and edited the manuscript.
Institutional review board statement: This study has been reviewed and approved by the Ethics Committee of Linquan County People's Hospital.
Informed consent statement: All patients and guardians have signed informed consent forms.
Conflict-of-interest statement: We all authors jointly declare that there is no conflict of interest.
Data sharing statement: No other available data.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Biao Zou, MSc, Associate Chief Physician, Cardiovascular Medicine, Linquan Country People’s Hospital, No. 206 Jianshe South Road, Linquan 236400, Anhui Province, China. qrbc892@163.com
Received: April 3, 2024
Revised: April 26, 2024
Accepted: May 10, 2024
Published online: June 26, 2024
Processing time: 75 Days and 19 Hours
Abstract
BACKGROUND

Coronary heart disease (CHD) and heart failure (HF) are the major causes of morbidity and mortality worldwide. Early and accurate diagnoses of CHD and HF are essential for optimal management and prognosis. However, conventional diagnostic methods such as electrocardiography, echocardiography, and cardiac biomarkers have certain limitations, such as low sensitivity, specificity, availability, and cost-effectiveness. Therefore, there is a need for simple, noninvasive, and reliable biomarkers to diagnose CHD and HF.

AIM

To investigate serum cystatin C (Cys-C), monocyte/high-density lipoprotein cholesterol ratio (MHR), and uric acid (UA) diagnostic values for CHD and HF.

METHODS

We enrolled 80 patients with suspected CHD or HF who were admitted to our hospital between July 2022 and July 2023. The patients were divided into CHD (n = 20), HF (n = 20), CHD + HF (n = 20), and control groups (n = 20). The serum levels of Cys-C, MHR, and UA were measured using immunonephelometry and an enzymatic method, respectively, and the diagnostic values for CHD and HF were evaluated using receiver operating characteristic (ROC) curve analysis.

RESULTS

Serum levels of Cys-C, MHR, and UA were significantly higher in the CHD, HF, and CHD + HF groups than those in the control group. The serum levels of Cys-C, MHR, and UA were significantly higher in the CHD + HF group than those in the CHD or HF group. The ROC curve analysis showed that serum Cys-C, MHR, and UA had good diagnostic performance for CHD and HF, with areas under the curve ranging from 0.78 to 0.93. The optimal cutoff values of serum Cys-C, MHR, and UA for diagnosing CHD, HF, and CHD+HF were 1.2 mg/L, 0.9 × 109, and 389 µmol/L; 1.4 mg/L, 1.0 × 109, and 449 µmol/L; and 1.6 mg/L, 1.1 × 109, and 508 µmol/L, respectively.

CONCLUSION

Serum Cys-C, MHR, and UA are useful biomarkers for diagnosing CHD and HF, and CHD+HF. These can provide information for decision-making and risk stratification in patients with CHD and HF.

Keywords: Serum cystatin C; Monocyte/high-density lipoprotein-C ratio; Uric acid; Coronary heart disease; Heart failure; Risk stratification

Core Tip: Serum cystatin C, monocyte/high-density lipoprotein cholesterol ratio, and uric acid are valuable biomarkers for diagnosing coronary heart disease (CHD) and heart failure (HF), with the potential for combined CHD + HF diagnosis. These biomarkers offer reliable diagnostic performance and are easily accessible through routine laboratory tests. Their use can enhance clinical decision-making and risk assessment in patients with CHD and HF, providing additional insights beyond traditional diagnostic methods. These biomarkers should be incorporated into diagnostic protocols to improve the accuracy and prognostic evaluation of patients with suspected CHD or HF.