OBJECTIVE

This study was conducted to investigate the feasibility of using the serum homocysteine (Hcy), C-reactive protein (CRP), and cystatin C (Cys-C) levels to evaluate the conditions and prognoses of acute myocardial infarction (AMI) patients.

METHODS

One hundred and twenty patients with AMI were enrolled as an observation group (the AMI group). Eighty patients with stable angina pectoris were included in a control group (the SA group). Eighty healthy volunteers were enrolled as a healthy control group (the NCHD group). The AMI patients were divided into groups of >20 (n = 32), 10-20 (n = 45) and <10 (n = 43) according to their APACHE-II scores. The groups were divided into a death group (n = 23) and a survival group (n = 97) according to the patients' 1-year follow-up outcomes. The differences in the serum Hcy, CRP, and Cys-C levels among the different groups, and the correlations between the serum levels were calculated.

RESULTS

The serum Hcy, CRP, and Cys-C levels in the AMI group were significantly higher than they were in the SA and NCHD groups (<0.05), and the serum levels in the APACHE-II score >20 group were significantly higher than the serum levels in the 10-20 group. The dead group exhibited higher serum Hcy, CRP, and Cys-C levels than the survival group (<0.05), and our Spearman's correlation analysis showed that the serum Hcy, CRP and Cys-C levels were positively correlated with the APACHE II scores (r = 0.9157, r = 0.8519, r = 0.8598, <0.001). The area under curve of Hcy, CRP, and Cys-C for the AMI diagnoses were 0.9638 (95% CI: 0.9183-1.000), 0.8125 (95% CI: 0.6652-0.9598), and 0.7515 (95% CI: 0.5847-0.9184), respectively.

CONCLUSION

Serum Hcy, CRP, and Cys-C levels can reflect the severity of the patients' conditions.