The Effect Of Folic Acid Intervention On The Concentration Of Hcy,FIB And Clinic Prognosis In Patients With Acute Coronary Syndrome After PCI

Objective:To investigate the effect on the concentration of homocysteine(Hcy)and fibrinogen(FIB)and the short-term prognosis after percutaneous coronary intervention(PCI)on patients with acute coronary syndromes(ACS)by using folic acid and Vitamin B12,and to provide a basis for clinical prevention and treatment of major adverse cardiovascular events(MACE),and to further improve the prognosis and life quality of patients.Methods:A total of 106 patients diagnosed with ACS and accept the therapy of PCI were selected for this study.They were divided into three groups: unstable angina(group A),non-ST-elevation myocardial infarction(USTEMI,group B),ST-segment elevation myocardial infarction(STEMI,group C).The patients in group A,B and C were randomly divided into treatment group and control group.All patients were given conventional drugs,including Aspirin,Clopidogrel,Statins,and Renin-angiotensinaldosterone inhibitor.The treatment groups were treated with folic acid and Vitamin B12 based on conventional drugs.The Hcy and FIB results of patients were measured at 4,12 and 24 weeks after PCI.After 24 and 48 weeks of PCI,the incidence of MACE events,including angina pectoris,nonfatal myocardial infarction,revascularization of infarctrelated blood vessels,and cardiac death,were recorded by outpatient or telephone.Results:The levels of Hcy and FIB in patients with acute myocardial infarction were obviously higher compared to patients with unstable angina,and the levels of Hcy and FIB in patients with ST-segment elevation myocardial infarction were higher compared to patients with non-ST-elevation myocardial infarction.For patients with unstable angina,non-ST-elevation myocardial infarction and ST-segment elevation myocardial infarction,after 4 weeks of PCI,the level of Hcy in treatment groups had significant differences compared with preoperative,and after 12 weeks of PCI,there were statistical differences between treatment groups and control groups.For patients with non-ST-elevation myocardial infarction and ST-segment elevation myocardial infarction,after 4 weeks of PCI,the levels of Hcy in control groups had significant differences compared with preoperative,but for patients with unstable angina,there was no statistical difference in control group compared with preoperative until 12 weeks later.For patients with unstable angina,non-ST-elevation myocardial infarction and ST-segment elevation myocardial infarction,after 12 weeks of PCI,the levels of FIB in treatment groups had significant differences compared with preoperative,and there were statistical differences between treatment groups and control groups.For patients with unstable angina and non-ST-elevation myocardial infarction,after 24 weeks of PCI,the levels of FIB in control groups had significant differences compared with preoperative,but for patients with ST-segment elevation myocardial infarction,after 12 weeks of PCI,there was statistical difference in control group compared with preoperative.For patients with ACS,after 24 and 48 weeks of PCI,although there were no significant differences between the treatment group and the control group in the recurrence rate of angina pectoris,the incidence of non-fatal myocardial infarction,the revascularization rate of infarct-related blood vessels and the cardiogenic mortality rate,there was a significant difference in the occurrence of MACE events between the two groups,and the difference was statistically significant with P<0.05.Conclusions:1.In this experiment,application of folic acid and vitamin B12 can reduce the concentration of Hcy and FIB in patients with ACS after PCI.2.In this experiment,application of folic acid and vitamin B12 can reduce the occurrence of MACE events in patients with ACS after PCI.