Effect of High Homocysteine Level on the Severity of Coronary Heart Disease and Prognosis After Stent Implantation

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.

Hyperhomocysteinemia and Acute Coronary Syndrome: A Hospital-Based Observational Study Among Very Young Adults ≤35 Years of Age

“…In their study, Shenoy et al [23] suggested that serum HCY level was signi cantly correlated with the Gensini Score of CAD patients (r = 0.443), which was consistent with our data. However, the sample size in a study conducted by Shenoy et al [23] was smaller, and the participants of Li et al [22] and Shenoy et al [23] study were much older compared with ours. In addition, Li and colleagues [22] also showed that the number of coronary artery target vessels in the HHCY group was obviously higher, and patients with high HCY levels had a higher proportion of coronary lesions.…”

“…However, the sample size in a study conducted by Shenoy et al [23] was smaller, and the participants of Li et al [22] and Shenoy et al [23] study were much older compared with ours. In addition, Li and colleagues [22] also showed that the number of coronary artery target vessels in the HHCY group was obviously higher, and patients with high HCY levels had a higher proportion of coronary lesions. Another study involving HCY levels and premature CAD (56.1 ± 6.2 years of age) in 2019 [24] showed that the HCY levels were signi cantly higher in patients with multi-vessel disease.…”

“…The results of this study showed a positive correlation between HHCY and angiographic severity expressed by Gensini Score. Li et al [22] studied 667 middle-aged and elderly CAD patients who underwent drug-eluting stent implantation and reported that patients with HHCY had a higher stenosis degree, as indicated by elevated SYNTAX scores. In their study, Shenoy et al [23] suggested that serum HCY level was signi cantly correlated with the Gensini Score of CAD patients (r = 0.443), which was consistent with our data.…”

Associations between hyperhomocysteinemia and the presence and severity of acute coronary syndrome in young adults ≤ 35 years of age

“…In their study, Shenoy et al [29] suggested that serum HCY level was significantly correlated with the Gensini Score of CAD patients (r = 0.443), which was consistent with this study. However, the sample size in the study conducted by Shenoy et al [29] was smaller, and the participants of Li et al [28] and Shenoy et al [29] study were much older. In addition, Li et al [28] also showed that the number of coronary artery target vessels in the HHCY group was obviously higher, and patients with high HCY levels had a higher proportion of coronary lesions.…”

“…The results of this study showed a positive correlation between HHCY and angiographic severity expressed by Gensini Score. Li et al [28] studied 667 middle-aged and elderly CAD patients who underwent drug-eluting stent implantation and reported that patients with HHCY had a higher stenosis degree, as indicated by elevated SYNTAX scores. In their study, Shenoy et al [29] suggested that serum HCY level was significantly correlated with the Gensini Score of CAD patients (r = 0.443), which was consistent with this study.…”