The Correlational Study Of Homocysteine And Uric Acid Level In Premature Coronary Heart Disease

Objective:To study the relationship of homocysteine(HCY) and uric acid (UA) level in premature coronary heart disease(CHD) patients,and provide clinical idea of early diagnose and treatment for premature CHD.Methods:Two hundred and seventy-eight hospitalized patients were enrolled in the reserch(male≤55years old,female≤65years old).All patients were divided into premature CHD group(n=192) and control group(n=86) according to coronary angio-graphy,they are118patients in male premature CHD group and53patients in control group,and74patients in female premature CHD group and33patients in control group.Basis on coronary lesions all the premature CHD patients were divided into single-vessel lesion group(n=77),double-vessel lesions group(n=63) and multi-vessel lesions group(n=52).According to clinical conditions,all the premature CHD patients were divided into AMI group(n=77),UAP(n=86) group and SAP group(n=39). Detailed informations were recored including age,gender,history of smoking, alcoholic,hypertension,diabets,the situation of the heart function, and history of atrial fibrillation.All patients were detectded HCY,UA and some other biochemical indicators levels.Comparing HCY and UA levels among different groups,and to study the relationship between HCY,UA leveland male,female premature CHD,heart failure and atrial fibrillation respectively.Results:1.HCY and UA levels were obviously higher in the premature CHD group patients than control group(P<0.01).HCY levels in AMI and UAP groups were higher than that in SAP group(P<0.01),and in AMI group was higher than in UAP group(P<0.01).HCY and UA levels were higher in the multi-vessel and double-vessel lesions groups than that in single-vessel lesions group(P<0.01or P<0.05),and UA level was higher in multi-vessel lesions groups than that in double-vessel lesions groups(P<0.05).2.HCY and UA levels were obviously higher in male and female premature CHD patients than those in control groups(P<0.01).male premature CHD patients’history of smoking,alcoholic,HCY and UA levels were higher than those in female premature CHD(P<0.01or P<0.05),but age,history of hypertension,diabets,HDL and TC levels were lower than those in female premature CHD(P<0.01or P<0.05).3.The Logistic regression analysis demonstrated smoking and HCY are independent risk factors in male premature CHD,and hypertension,HCY and UA are independent risk factors in female premature CHD.The ROC area under curve of HCY and UA for male premature CHD separtely were88.8%and73.3%,and which for female premature CHD separtely were86.0%and75.5%.4.HCY and UA levels were higher in premature CHD heart failure group NYHAIII-IV than in NYHAⅡ and no-heart failure group,and HCY level in heart failure NYHAⅡ patients was higher than in no-heart failure group(P<0.01or P<0.05).5.HCY and UA levels were higher in atrial fibrillation group of premature CHD than in no-atrial fibrillation group.UA was an independent risk factor in atrial fibrillation of premature CHD.HCY levels were higher in permanent and persistenct atrial fibrillation groups than those in paroxysmal atrial fibrillation group(P<0.05).Conclusions:1.HCY and UA levels in premature CHD group patients were all obviously higher than in control group,and the more coronary lesions,the higher HCY and UA levels.2.HCY and UA levels have close relations with male and female premature CHD patients.HCY was an independent risk factor in male and female premature CHD.UA was an independent risk factor in female premature CHD,but not an independent risk factor in male premature CHD.3.The area under curve of ROC indicated that HCY’diagnostic value for male and female premature CHD was preferable accuracy.and better than UA diagnostic value.4.HCY and UA levels have close relations with premature CHD patients occur heart failure,and the higher the levels,the more serious the heart failure.5.HCY and UA levels have relativity in premature CHD atrial fibrillation patients.UA was an independent risk factor in atrial fibrillation.The HCY level was different among subgroups,which has relation with duration of atrial fibrillation.