| OBJECTIVES: To determine serum homocysteine (Hcy) levels in patients withthe chief complaint of chest pain, chest tightness or palpitations and to evaluate thecorrelation between Hcy and CHD, unstable atherosclerotic plaque and riskstratification for non-ST elevation acute coronary syndrome(non-STEACS).METHODS:260patients accepting coronary angiography(CAG) were selected,without diabetes,176patients as CHD group and84patients as a non-CHD groupfrom Center Hospital of Lou Di, with the chief complaint of chest pain, chesttightness, and palpitation from October2012to February2014. Demographic dataincluding gender, age, smoking history, medical history, and tested blood pressure,liver and kidney function, serum Hcy, uric acid, glucose, lipids, hs-CRP, D-D,NT-proBNP, creatine kinase and creatine kinase, and calculated number of diseasedvessels and conducted Gensini score according to the result of CAG.All of samples were divided into four groups: zero-vessel disease group, mono-vessel disease group, bi-vessel disease group, and multi-vessel disease group. Eachgroup was compared among serum Hcy, lipids and blood uric acid levels. The patientswere divided into four groups:group1: points=0points, group2:0<points≤20points, group3:20points <points≤40points, group4points>40points,according to Gensini scores. The CHD group was further divided into another twogroups: acute coronary syndrome group (ACS)(124examples) and stable anginapectoris group (SAP)(52patients), compared serum Hcy, LDL-C and hs-CRP, andanalyzed its correlation with Gensini score and serum Hcy, LDL-C, and hs-CRP. Thepatients of non-ST segment elevation acute coronary syndrome were divided intoanother three groups: low risk group, moderate risk group and high risk groups,according to the TIMI risk score, whose TIMI risk scores were calculated to analyzecorrelation between serum Hcy levels and TIMI risk score. RESULTS:1.CHD and non-CHD group had no statistically significant difference amonggender, age, smoking history, body mass index, blood pressure (P>0.05).2.Serum Hcy levels of Gensini group2was higher than Gensini group1[(16.02±4.73) umol/L vs.(13.31±4.19) umol/L,(P <0.01)]. Gensini3group washigher than Gensini group1[(19.02±4.37) umol/L vs (13.31±4.19). umol/L,(P <0.01)] and Gensini group2[(19.02±4.37) umol/L vs (16.02±4.73) umol/L,(P <0.01)]. Gensini group4was higher than Gensini group2[(19.82±4.15)umol/L vs.(13.31±4.19) umol/L,(P <0.01)].[(19.82±4.15) umol/L vs(16.02±4.73)umol/L,(P <0.01)]. There was no statistically significant differencebetween Gensini group4and Gensini group2(P>0.05).Serum Hcy levels werepositively correlated with Gensini score.3. Serum Hcy levels of mono-vessel coronary disease was significantly higherthan zero-vessel disease [(17.26±3.23) umol/L vs (12.96±2.99) umol/L,(P<0.01)]. Bi-vessel disease was dramatically higher than zero-vessel disease [(19.01±3.50) umol/L vs (12.96±2.99) umol/L,(P <0.01)]. There was no statisticallysignificant difference between the bi-vessel disease and the zero-vessel disease (P>0.05). Serum Hcy levels of multi-vessel disease was significantly higher thanzero-vessel disease [(19.67±3.43) umol/L vs (12.96±2.99) umol/L,(P<0.01)] and mono-vessel disease [(19.67±3.43) umol/L vs (17.26±3.23)umol/L,(P <0.05)]. There was no statistically significant difference between the bi-vesseldisease and multi-vessel disease (P>0.05).4.Serum Hcy levels of SAP group was slightly higher than non-CHD group (P<0.05). Serum Hcy levels of ACS group was higher than SAP group (P <0.05), andnon-CHD group (P <0.01).5.Serum Hcy, LDL-C, hs-CRP were positively correlated with Gensini score (r=0.432P=0.000, r=0.423P=0.001, r=0.328P=0.009) in ACS patients.6.Hcy levels of low risk group were less than those of moderate risk group(P<0.05) and high risk group (P <0.01). Hcy levels of moderate risk group were alittle less than high risk group (P<0.05) in non-ST-segment elevation ACS patients. Serum Hcy levels were positively correlated with TIMI risk score (r=0.365P<0.01)in non-ST-segment elevation ACS patients.CONCLUSIONS:1.Serum Hcy levels of CHD group was slightly higher than non-CHD group2.Serum homocysteine levels were positively correlated with unstableatherosclerotic plaque.3.Serum Hcy levels of UAP group was higher than SAP group... |
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