The Correlation Between Plasma Homocysteine And Coronary Heart Disease And The Study On Its Mechanism

BackgroundThe latest data released by the World Health Organization (WHO),2009: cardiovascular disease has emerged as the crowd cause of death constitute the disease than was ranked first. With the aggravation of the economic and social development in China, as well as the aging of the population, the proportion of cardiovascular disease morbidity and mortality in our population increasing, and there is a trend to younger, cardiovascular disease has become residents the cause of death of the fastest rising disease, a serious threat to the health of our public.A statistical bulletin of health development Ministry of Health issued in China in2008shows:heart disease was the second cause of death of urban residents, the fourth of rural residents, second only to malignant tumors, which is the second cause of death among China’s population. The highest prevalence of heart disease is the coronary heart disease, traditional risk factors only partially explain the occurrence of coronary heart disease, there may be other factors involved,cardiovascular experts through epidemiologypractice surveys and clinical scientific research had a conclude that plasma homocysteine (homocysteine, Hcy) level is closely linked to cardiovascular cerebrovascular diseases, and speculated that a high level of hyperhomocysteinemia is one of the important independent risk factors that leads to cardiovascular and cerebrovascular disease.in1969, it was found that Hcy may be related to atherosclerosis and artery and that a series of objective evidence by a large number of clinical studies,.For a long time, homocysteine hyperlipidemia is considered to be atherogenicindependent risk factor for hardening.However, some studies in recent years suggest that there was no significant relationship between plasmahomocysteine levels and atherosclerosis, hyperhomocysteinemia does not increase the number of coronary vascular lesions, Hcy elevation may be just the diseaseprocessa ccompanied by the phenomenon, rather than lead to atherosclerosis risk factors in populations of other cardiovascular and cerebrovascular disease risk factors, homocysteine alone does not increase the incidence of cardiovascular and cerebrovascular diseases. Many results of clinical trials show that lowering plasma homocysteine can not delay the occurrence of atherosclerosis development andcardiovascular disease. And over more than ten years, there can’t have a conclusion that hyperhomocysteinemia whether is an independent risk factor for coronary heart disease debate different.Objective1. To investigate the correlation between plasma homocysteine and the traditional risk factors of CHD and Through non-conditional multiple logistic regression analysis to determine whether Hyperhomocysteinemiae is an independent risk factor of CHD.2. To analysis the relationship between plasma homocysteine and hs-CRP、 fibrinogen (FIB)、D-dimer (D-DT) of CHD to analysis the mechanism of how hyperhomocysteinemiae resulting in coronary heart disease.MethodsOne hundred and eighty patients were selected for study from the inpatients of Zhengzhou University, Department of cardiology taken in from2010and Oct211,all the selected patients received coronary angiography,and all patients were ruled out liver and kidney disease, cancer, malnutrition, half year not vitamin, folic acid kind of medicine and ammonia armour Die influence of plasma Hcy methotrcxate drugs.The fasting total serum homocysteine(Hcy), high-sensitivity C-creactivc protein(hs-CRP), serum levels of total cholesterol (TC) and plasma fibrinogen (FIB) and D-dimer (D-DT) of109coronary heart disease (CHD)(including acute coronary syndrome (ACS)71and stable angina (SAP)38) and71control group (NC) were measured respectively.Prior medical histories including:sex,age,essential hypertension,,diabetes mellitus,high cholesterol and smoking. To analysis the Hcy level between heart disease and NC group, and analysis the level of plasma Hcy, FIB, D-DT, hs-CRP SAP between the group of ACS, SAP and NC. as dependent variable coronary heart disease, gender, age, TC, Hcy, smoking history, high blood pressure, diabetes, hs-CRP, FIB, D-DT as independent variables, as many factors through Logistic regression analysis, To analysis the correlation between plasma homocysteine and hs-CRP、fibrinogen (FIB)、D-dimer (D-DT) of CHD.Results1. The blood plasma Hcy, FIB D-DT and blood blood plasmahs-CRP, levels of SAP group and ACS group were much higher than those of NC group (P<0.05), and the blood plasma Hcy, hs-CRP levels of SAP group were much higher than those of NC group (P<0.05),but there was no discrepancy in levels of FIB and D-DT between SAP group NC group.2. Plasma Hcy level was significantly higher in the CHD group than in the control (P<0.01) and the percentage of Hyperhomocysteinemia in the CHD group was significantly higher than in the control(P<0.01).After many factors unconditional Logistic regression anylysis,Hyperhomocysteinemia on CHD the relative risk (OR) was1.118(P<0.01).3. There was discrepancy in levels of Hcy between cases with different sex (P<0.01),and no correlation between age (P>0.05) and there was no discrepancy in levels of Hcy between cases with different history of hypertension,diabetes mellitus, high cholesterol and smoking status (P>0.05). The blood plasma Hcy levels of CHD group was correlated respectively with hs-CRP, FIB and D-DT (P<0.05). Conclusion1. Hyperhomocysteinemia is an independent risk factor of coronary heart disease.2. Plasma Hcy may through the inflammatory reaction and make the organism in the state of before thrombus, increasing the risk of coronary heart disease.