A Study Of Correlation Between Plasma Homocysteine And Acute Coronary Syndrome

Objectives:To measure HCY plasma concentration in patients with acute coronary syndrome (ACS) after confirmed diagnosis by clinic data and to explore the relationship between the levels of plasma HCY and the severity of ACS.Methods:This study was conducted with193ACS patients and67nomal subjects randomly. The blood specimens were collected after on the second morning with a fasting status. Coronary angiography was carried out on all selected objects, ruled out other heart diseases such as an dilated cardiomyopathy, hypertrophic cardiomyopathy, rheumatoid cardiomyopathy, hyperthyroidism cardiomyopathy, abnormal of kidney and liver function and infection, malignant tumor,diabetes, problems of the blood system, respiratory system disease and immune system disease. A total of260objects were selected, which were divided into four groups,65cases of acute ST-segment elevation myocardial infarction group,59cases of the non-ST-segment elevation myocardial infarction group,69cases of unstable angina pectoris group and67subjects with normal control group. All subjects were recorded general situation, the ages, blood fat and CAG results. All subjects were determined by high performance liquid chromatography (HPLC) method to investigate plasma HCY concentration and all data was processed by SPSS17.0package for statistical analysis.Results:(1) Plasma HCY levels of the acute ST-segment elevation myocardial infarction(STEMI) group were14.88±3.92; plasma HCY levels of the non-ST-segment elevation myocardial infarction(NSTEMI) group were14.70±3.32; plasma HCY level of unstable angina pectoris were13.99±3.29. Threre were not statistical significance among three groups plasma HCY levels difference (P>0.05).±Plasma HCY levels of the control group were10.88±2.96. There were significantly statistical significance between the three groups plasma HCY levels difference and the control group (P<0.01).(2) Acute coronary syndrome groups and control group were categoried into4count groups according to coronary artery lesions count:plasma HCY levels of the control group(67cases)were10.88±2.96; plasma HCY levels of single vessel lesion group (79cases) were13.40±2.73; plasma HCY level of double vessel lesions group (64cases) were14.44±3.60and plasma HCY level of three lesions group (50cases) were16.33±3.85. Single lesion group,double vessel lesions group,and three lesions group of plasma HCY levels were obviously higher than that of the control group(P<0.01). To group of single-vessel lesion, double-vessel lesions group, and three-vessel lesions, three lesions plasma HCY levels were higher than the single-vessel group and double-vessel disease group,a statistically significant difference (P<0.05).To single vessel group and double-vessel disease group plasma HCY levels, the difference was not statistically significant(P>0.05).(3) There were remarkable statistical significance between levels of plasma HCY and coronary artery lesions count, rs=0.496(P<0.01), through correlation analysis. Plasma HCY levels and coronary artery lesions count were positively related.(4) Multivariate unconditional logistic regression analysis indicated that HHCY was an independent risk factor of ACS.Conclusions:The levels of plasma HCY and acute coronary syndrome are relevant and may reflect the coronary artery lesions.In acute coronary syndrome groups of patients, plasma HCY levels are obviously higher than that in the control group. The more serious coronary artery lesions are, the higher plasma HCY concentratoion is. Therefore, in some extent, plasma HCY levels can be regarded as an indicator used to guide disease assessment of clinical acute coronary syndrome. There are postively correlated with between plasma HCY levels and fibrinogen in acute coronary syndrome patients.Due to plaque instability or rupture in ACS patients, the blood is hypercoagulable, HHCY hyperlipidemia may exacerbate the hypercoagulable state and promote the development of acute coronary syndrome. Plasma hyperhomocysteinemia may be an independent risk factor for acute coronary syndrome and the degree of danger is lower than total cholesterol and fibrinogen, higher than that of ucidum uricum.