| Objective:To investigate the changes of blood homocysteine level in patients with acute coronary syndromes and the influencing factors, and to analyze the correlation between blood homocysteine level and the severity of coronary artery lesions. Method:The case group: 88 cases of acute coronary syndrome(ACS)(including: 46 cases NSTE- ACS and 42 cases STEMI) who visited the Internal Medicine-Cardiovascular Department of our hospital within 48 hours after onset from January 2014 to December 2014; the control group: 44 cases of stable angina-pectoris(SA) and 44 cases of non-coronary artery disease(non-CHD) admitted in the same period were selected. The fasting blood samples of all candidates included were collected for detection of homocysteine(Hcy), and the patients’ gender, age, blood lipid, BMI, history of smoking and hypertension and other clinical data were also collected; in the case group, the patients underwent coronarography and the coronary SYNTANX scores were achieved based on imaging results. Analysis of the differences of Hcy level between the groups, investigate ofthe relastionship between blood homocysteine levels and traditional risk factors. Analysis correlation between Hcy and coronary score in case group. Results:1.The comparison of baseline data: no statistical difference was found in gender, age, BMI, blood lipid level, diabetes history, hypertension history and history of smoking between ACS group and the control group(P >0.05); 2. Blood Hcy: the group comparison indicates that ACS groups have significantly higher blood Hcy levels than the SA group and non-CHD group(20.64 ± 9.72 vs 14.85 ± 5.01umol/L, P<0.01; 20.64 ± 9.72 vs 13.55 ± 5.16umol/L, P<0.05), while the blood Hcy level is ordered as ACS group>SA group>non-CHD group, and the differences are statistically significant(P<0.05); the ACS group comparison shows that STEMI group and NSTE-ACS group differ insignificantly in blood Hcy level(21.38 ± 9.87 vs 19.98± 9.65 umol/L, P>0.05). 3. ACS group blood Hcy and traditional cardiovascular risk factors: no difference of blood Hcy level was found between different genders( 21.01 ± 9.63 vs 20.18± 9.97 umol/L, P=0.69); the patients who smoke have significantly increased blood Hcy level than non-smokers(26.04±11.22 vs 19.03± 8.80umol/L, P=0.03); the blood Hcy in the patients with hypertension and diabetes also obviously increased(22.35 ± 9.44 vs 17.81 ±12.86umol/L, 25.79± 13.22 vs19.23 ±9.01 umol/L, P<0.05); blood Hcy level is positively related to patients’ BMI(r=0.57, P < 0.05) and age(r=3.01, P < 0.05), but not remarkably correlated with blood lipids(r=0.07, P> 0.05); 4. the blood Hcy and coronary SYNTANX scores of ACS groups: STEMI group has marked higher score than NSTE-ACS group(24.25±6.68 vs 19.63 ± 6.90, P=0.02); the linear analysis of single factor of blood Hcy level and coronary SYNTANX score indicates significant correlation between them(r=0.78, P < 0.05); multivariate linear analysis of all indexes and coronary SYNTANX scores manifests that coronary SYNTANX scores are significantly related to all indexes(r=0.85, P<0.05), and independently associated with age(P=0.03,95%CI:0.05-0.27), BMI;(P=0.00, 95%CI, 0.26-0.54)and blood Hcy. Conclusion:1.The blood Hcy level in ACS patients were significantly increased, serum Hcy is usefull for acute coronary syndrome early monitoring,clinical diagnosis, risk stratification and prognostic evaluation.2.The blood Hcy closely related to the conventional risk factors for CHD, age, gender, abnormal metabolism, smoking and other factors can cause elevated blood levels of Hcy.3. The serum Hcy level in patients with acute coronary syndrome is positively related to the degree of coronary artery lesions,is a risk factor for the severity of coronary artery disease. |
PDF Full Text Request