Molecular and Cellular Biochemistry

, Volume 389, Issue 1–2, pp 59–68 | Cite as

The potential of Cystatin C and small dense LDL as biomarkers of coronary artery disease risk in a young Indian population

  • Anjali Manocha
  • Flora Gupta
  • Rajneesh Jain
  • Seema Bhargava
  • Mamta Kankra
  • Sabari Das
  • L. M. Srivastava


Coronary artery disease (CAD) affects Indians 5–6 years earlier than in the west, is diffuse and malignant, and poses a heavy burden on India’s developing economy. Traditional risk factors have failed to explain this high incidence of premature CAD and hence this study investigated the association of two novel risk biomarkers, cystatin C and small dense LDL (sdLDL) with the presence and severity of CAD. Cystatin C and sdLDL were estimated in 204 CAD patients ≤45 years of age and compared with 161 age-matched healthy controls. The traditional lipid profile parameters, i.e., cholesterol, LDL, HDL, triglycerides, apolipoproteins A1 and B, and Lp(a) were also measured in both groups. Cystatin C was significantly raised and mean LDL particle size significantly reduced in CAD patients as compared to controls. 62.7 % of CAD patients showed pattern B while 37.3 % patients showed pattern A. Of the traditional lipid tests, only HDL and apolipoprotein A1 showed a significant decrease in the CAD group. sdLDL was significantly associated with the severity of CAD, while cystatin C was not. Both cystatin C and sdLDL emerged as independent risk factors, however, of the two, sdLDL was a more sensitive predictor of CAD events. Cystatin C and mean LDL particle size are significantly and independently associated with the presence of CAD events in patients ≤45 years with normal kidney function. Hence, these novel risk biomarkers can be useful tools in reducing the morbidity and mortality associated with CAD in the productive Indian workforce.


Cystatin C Small dense LDL Early detection Coronary artery disease Risk factors 



This study was supported by a research grant from the Indian Council of Medical Research (ICMR), New Delhi, India. We also acknowledge, with thanks, the help provided in the statistical analysis by Ms. Parul Takkar Chugh, Statistician, Sir Ganga Ram Hospital, New Delhi, India.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Anjali Manocha
    • 1
  • Flora Gupta
    • 1
  • Rajneesh Jain
    • 2
  • Seema Bhargava
    • 1
  • Mamta Kankra
    • 1
  • Sabari Das
    • 1
  • L. M. Srivastava
    • 1
  1. 1.Department of BiochemistrySir Ganga Ram HospitalNew DelhiIndia
  2. 2.Department of CardiologySir Ganga Ram HospitalNew DelhiIndia

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