Effect of High Homocysteine Level on the Severity of Coronary Heart Disease and Prognosis After Stent Implantation
Shanshan Li, Liping Sun, Liqun Qi, Yongsheng Jia, Zhuo Cui, Zhongsuo Wang, Fengshuai Li, Xiaofeng Zhao
Abstract
OBJECTIVES: To determine the effect of high homocysteine (HCY) levels on the severity of coronary artery disease and prognosis after stent implantation. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.