Cardiology.
Infection Management, Huludao Center Hospital, Huludao, Liaoning, People's Republic of China and.
J Cardiovasc Pharmacol. 2020 Jul;76(1):101-105. doi: 10.1097/FJC.0000000000000829.
To determine the effect of high homocysteine (HCY) levels on the severity of coronary artery disease and prognosis after stent implantation.
A prospective study was conducted on 667 patients with coronary heart disease who underwent drug-eluting stent implantation for the first time at the Department of Cardiology, Huludao Central Hospital, from January 2015 to December 2017. The patients were divided into the control and hyperhomocysteinemia (H-HCY) groups based on the serum HCY levels. The demographic and clinical characteristics of both groups were compared. In addition, the patients were followed up for 1 year to compare the incidence of major adverse cardiovascular and cerebrovascular events (MACCE). Multivariate logistic regression was used to determine the correlation between serum HCY levels and MACCE.
Compared with the control group, the stenosis degree was significantly higher among patients in the H-Hcy group, as indicated by more coronary artery lesions (P < 0.001) and higher SYNTAX scores (P < 0.001). After 1 year of follow-up, the incidence of MACCE was also significantly higher in the H-HCY versus control group (9.5% vs. 15.1%; P = 0.042). Furthermore, age, history of diabetes, discontinuation of antiplatelet aggregation drugs, and HCY levels were independent predictors of MACCE.
High HCY level is associated with severe coronary artery disease in patients with coronary heart disease and is an independent predictor of MACCE after stent implantation.
探讨高同型半胱氨酸（HCY）水平对冠状动脉疾病严重程度及支架植入术后预后的影响。
选取 2015 年 1 月至 2017 年 12 月在葫芦岛市中心医院心内科首次行药物洗脱支架植入术的 667 例冠心病患者为研究对象，根据血清 HCY 水平分为对照组和高同型半胱氨酸血症（H-HCY）组，比较两组患者的一般资料及临床特征，随访 1 年比较两组主要不良心脑血管事件（MACCE）的发生情况，采用多因素 Logistic 回归分析血清 HCY 水平与 MACCE 的相关性。
与对照组相比，H-HCY 组患者的狭窄程度更高，冠状动脉病变更多（P<0.001），SYNTAX 评分更高（P<0.001）。随访 1 年，H-HCY 组 MACCE 发生率也明显高于对照组（9.5%比 15.1%；P=0.042）。进一步多因素 Logistic 回归分析显示，年龄、糖尿病史、抗血小板聚集药物停药和 HCY 水平是 MACCE 的独立预测因素。
高 HCY 水平与冠心病患者严重冠状动脉疾病相关，是支架植入术后 MACCE 的独立预测因素。
