Effects Of Hyperhomocysteinemia On Myocardial Injury And Inflammatory Reaction In Patients With Chronic Stable Coronary Atherosclerotic Heart Disease

Objective To study the effects and its potential mechanism of hyperhomocysteinemia(HHcy)on myocardial injury and in patients with chronic stable coronary atherosclerotic heart disease(SCAD).Methods We successively collected patients with SCAD admitted to the Department of Cardiology,Shengjing Hospital from September 2015 to February 2018.Based on the patient's plasma homocysteine(Hcy)concentration,they were divided into two groups: control group(Hcy<15 ?mol/L)and HHcy group(Hcy?15 ?mol/L).Serum levels of Hcy were measured by the method of circulating enzymology,Serum levels of hs-c TnT and NT-proBNP levels were measured by chemiluminescence,Serum levels of IL-6 and TNF-? levels were was detected by enzyme-linked immunosorbent assay(ELISA).Observe the level of plasma homocysteine and the level of myocardial injury markers such as hs-cTnT,inflammatory cytokines interleukin 6(IL-6)and tumor necrosis factor-?(TNF-?)levels relationship and so on.Results Serum hs-cTnT level in HHcy group(n=52)was higher than that in contro l group(n=52),(0.0088±0.0025 vs.0.0048±0.0015 ng/mL,P=0.000).Serum IL-6(14.64±3.40 vs.6.18±2.27 pg/mL,P=0.000)and TNF-?(The level of 24.65±4.81 vs.20.97±2.45 pg/mL,P=0.000)levels in HHcy group were also significantly higher than those in control group.Pearson correlation analysis showed that plasma Hcy levels were positively correlated with serum hs-cTnT(r = 0.698,P = 0.000),IL-6(r = 0.888,P = 0.000)and TNF-?(r = 0.596,P = 0.000),respectively.Further correlation analysis observed that serum hs-cTnT level was significantly related to gender(r = 0.297,P = 0.002),age(r = 0.293,P = 0.003),TC(r =-0.228,P = 0.020),LDL-C(r =-0.203,P = 0.038),Cr(r = 0.521,P = 0.000)and UA(r = 0.253,P = 0.010)levels and negatively correlated with eGFR(r =-0.343,P = 0.000).All related variables were input using binary linear logistic regression to observe the risk factors affecting serum hs-cTnT levels.After adjustment,plasma Hcy(R2=0.446,?=0.363,p=0.000)level was an independent risk factor for serum hs-cTnT level in SCAD patients.Furthermore,NT-proBNP level(320.98±471.62 vs.74.84±64.56 ng/mL,P=0.008)was significantly higher in HHcy group than that in the control group,and Pearson correlation analysis showed a significantly positive correlation between plasma Hcy and NT-proBNP(r=0.440,P=0.000).In addition,Pearson bivariate correlation analysis showed a significant positive correlation between hs-cTnT and NT-proBNP levels(r=0.415,P=0.000).Conclusion The increased plasma Hcy level is an independent risk factor for myocardial injury in SCAD patients,which may be explained by HHcy-related systemic inflammatory responses.Moreover,plasma Hcy level may be related to future cardiovascular events of SCAD patients.