The Correlative Study Between High Homocysteine And The Prediction Of Coronary Artery Heart Disease, Stroke

ObjectiveTo explore homocysteine (homocysteine, HCY) and coronary heart disease (Coronary heart disease, CHD), stroke (Stroke) and the relationship between the prognosisMethods234 patients with CHD or Stroke were randomized into two groups:110 patients in control group and 124 patients in study group.The average age is (69.35±11.40) years old. Male is 119 cases and female is 115.The randomized method as that:234 random numbers generated by EXCEL function were distributed to the patients according to the admission order.The control group was in odd array and the study group in the dual.The control group was given antihypertensive therapy(Diuretics, Calcium antagonists, Converting enzyme inhibitors,Angiotensin II receptor antagonists.β─blockers),lipid—adjusting (Statins,Bate, Niacin),hypoglycemic(Sulfonylurea,Biguanide,Glucosidase inhibitors, Insulin),anti-platel- et aggregation(Aspirin,Clopidogrel,Cilostazol) and other comprehensive treatments;study group is basing on the control group adding the oral folic acid tablets 10mg per day. Following up for one year,these parameters have been studied the changes in plasma Hcy levels for before treatment, 6 months after treatment,12 months after treatment,the inciden- ce of clinical adverse event with coronary artery heart disease(acute left heart failure, acute myocardial infarction,sudden cardiac death,Angina pectoris attack and arrhythmia) or Stro- ke (apoplexy,transient ischemic attack or reversible ischemic injury,cerebral hemorrhage ) after 6 months treatment, after treatment 12 months which were in order to study the corre- lation between Hcy levels and the incidence of clinical adverse event with CHD and Stroke.Results The plasma Hcy levels of the study group before treatment and 6 months after treatment compared with the control group were no significant differences(P>0.05). However,the 12 months after treatment of plasma Hcy were significantly lower than the control group(P<0.05 or P<0.01).The incidence of clinical adverse event with CHD and Stroke in the study group is 11.02%,but the control group is 26.92% which is larger than the former. The incidences of clinical adverse event with CHD and stroke were 11.02%,26.92% in Study group and control group.The difference between two groups was statistically significant(P<0.05).The results in Logistic regression analysis show that the incidence of clinical adverse event with CHD and Stroke is related with diabetes mellitus and high Hcy (P<0.05 or P<0.01),moreover,high Hcy is an risk factor.ConclusionAfter long-term oral folic acid tablets can significantly lower the level of plasma Hcy, and with oral folic acid tablets,the longer the more obvious reduction in the level of plasma Hcy.After long-term prophylactic use of folic acid tablets reduce plasma HCY levels by reducing coronary heart disease,stroke incidence of clinical events,so that early intervention Hcy levels on coronary heart disease,the prognosis of stroke is important,but also indicated that high Hcy and cardiac Closely related to cerebral vascular disease,can be used as an important secondary prevention measures,At the same time by coronary heart disease,stroke risk factors of clinical events Logistic regression analysis is an important risk factor for diabetes,blood glucose levels must be controlled to reduce the incidence of clinical events and improve coronary heart disease, stroke prognosis.SignificanceHcy can be used as coronary heart disease,stroke,a new independent risk factor,is a strong predictor of its effective control of Hcy levels can be prevention and treatment of coronary heart disease,stroke and new links.Oral folic acid tablets by lowering plasma Hcy levels,thereby reducing coronary heart disease,stroke incidence of clinical events,both to improve the economic practicality,but also on the above two of the most common cardiovascular disease prevention and treatment of new Ideas, feasibility is higher.