Abstract
BACKGROUND: Non-fasting blood lipid indexes and Cystatin C (CysC) are related to coronary artery stenosis, while the predictive value of their combination is unknown. This study aimed to investigate the ability of their combination to predict the degree of coronary artery stenosis. METHODS: Totally, 194 patients who underwent coronary angiography were included. Data on non-fasting blood lipid indexes, including triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (ApoB), apolipoprotein A-1 (ApoA1), and ApoB/ApoA1, as well as CysC were collected. A degree of coronary artery stenosis ≥ 70% was considered as severe coronary artery stenosis. RESULTS: There were 101 (52.1%) patients with severe coronary artery stenosis. HDL-C (P < 0.001) and ApoA1 (P = 0.010) were negatively associated with severe coronary artery stenosis, while LDL-C (P < 0.001), ApoB (P < 0.001), ApoB/ApoA1 (P < 0.001), and CysC (P < 0.001) were positively associated with severe coronary artery stenosis. HDL-C, LDL-C, ApoB, ApoA1, ApoB/ApoA1, and CysC showed area under curves (AUCs) of 0.685, 0.727, 0.764, 0.607, 0.806, and 0.703 in predicting severe coronary artery stenosis. Meanwhile, ApoB/ApoA1 (odds ratio (OR) = 86.857, P = 0.003) and CysC (OR = 31.070, P < 0.001) were positively and independently related to severe coronary artery stenosis. The combination of ApoB/ApoA1 and CysC exhibited a promising predictive value in predicting severe coronary artery stenosis, with an AUC of 0.850. CONCLUSION: Non-fasting blood lipid indexes and CysC are associated with severe coronary artery stenosis in patients who undergo coronary angiography, and the combination of ApoB/ApoA1 and CysC is enough to show a promising predictive value for predicting severe coronary artery stenosis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13019-026-03855-x.