Clinical Study On The Relationship Between Homocysteine And Coronary Heart Disease

Objective: (1)By analyzing the levels of serum homocysteine in groups with coronary heart disease(CHD) and controls ,in groups with different diagnostic classification of CHD ,and in groups with different severity of coronary lesions, to investigate the correlation between serum homocysteine (HCY) level and CHD.(2)To investigate the relationship between serum HCY level and conventional risk factors of CHD such as sex, age, hypertension, diabetes, cigarette smoking and blood lipid.(3)To investigate the relative risk ofHCY in onset of CHD.Methods: (1)With case-control study, 153 subjects who underwent coronary angiography were recruited in this study. Cases with 50% stenosis in at least one of the three coronary vessels were defined as CHD by angiography.While cases with <50% stenosis in all the three coronary vessels were considered as controls. CHD group had 105 patients aged 38~ 77 (57.46+10.10) including 80 men and 25 woman . The control had 48 people aged 32-72 (54.1 ± 10.50) including 30 men and 18 women . CHD group were further divided into single-vessel(n=25), double-vessel(n=31) and triple-vessel group(n=49) by coronary angiography, and divided into Acute Myocardial Infarction (AMI)(n=52), Old Myocardial Infartion (OMI) (n=ll), Unstable Angina Pectoris (UAP) (n=32) and Stable Angina Pectoris(SAP) (n=10) by clinical diagnostic classification. All groups were matched by age, sex and smoking, not including the patients with cerebrovascular disease, peripheral vascular disease or hepatic and renal disease, and all subjects had not taken drugs that might have an influence on serum HCY within half an year.The fluorescence polarization immunoassay (FPIA) was used to assess the level of serum HCY in the patients. (2) The serum triglyceride(TG), total cholesterol(TC), high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein -cholesterol (LDL-C) of 105 cases with CHD were measured by the full automatic biochemical analysator of Hitachi 7600-020. Prior medical histories including hypertension, diabetes, cigarette smoking status were obtained form all subjects via a questionnaire.(3)By statistical analysis, the difference of HCY between CHD group and control, among groups of different diagnostic classification of CHD and among groups of different severity of coronary lesions were acquired.The difference of HCY among groups according to sex , age , hypertention, diabetes, cigarette smoking and blood lipid were also acquired.The exist of correlations between homocysteine and conventional risk factors of CHD were decided.The relative risk of HCY in onset of CHD were acquired.Results: (1) By balanced test, there was no difference in sex, age and smoking between the CHD group and the control ,among CHD groups with lesions in 0, 1,2 and 3 vessels ,among CHD groups with different diagnostic classifications .This excluded the influence by three factors on levels of HCY and strengthened the credibility of results. (1)Serum HCY level was significantly higher in the CHD group than in the control [(22.89± 13.31) u mol/L versus (10.33 ±3.44) u mol/L,P<0.001].In the CHD group, 58.10% of the patients were found to have Hyperhomocysteinemia, significantly higher than in the control(16.67%, P<0.001). (2)In patients with lesions in 0, 1, 2 and 3 vessels, their HCY level tended to increase, with the number of vessel to be involved .A significant discrepancy was found between HCY levels in the...