Evaluation of Homocysteine in the Diagnosis and Prognosis of Coronary Slow Flow Syndrome

Li, Nan; Tian, Liuyang; Ren, Jiefeng; Yang, Li; Liu, Yuqi

doi:10.2217/bmm-2018-0446

Cited by 11 publications

(12 citation statements)

References 15 publications

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“…23 Demirci et al 16 showed that patients with SCF had significantly higher plasma tHcy levels than those with normal coronary flow. Li et al 14 found HHcy and mean platelet volume to be independent risk factors for SCF in a Chinese Han population. The coronary microvasculature is the dominant gatekeeper for myocardial blood flow below the visible epicardial arteries.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 Homocysteine is a sulfur-containing amino acid that functions as a key intermediate in methionine metabolism and hyperhomocysteinemia (HHcy) is well established risk factor for cardiovascular disease. 8 Angiographic findings [9][10][11][12][13][14][15][16] found that patients with SCF had significantly higher plasma total homocysteine (tHcy) levels than those with normal coronary flow and HHcy was strongly correlated with SCF phenomenon in patients without organic coronary stenosis. In addition, HHcy was a potential predictor for SCF prognosis and related to cumulative cardiac events.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, HHcy was a potential predictor for SCF prognosis and related to cumulative cardiac events. 14 Moreover, Li et al 17 observed that increased plasma tHcy levels (≥17.55 μmol/L) were independent negative predictor of spontaneous reperfusion (defined as achievement of TIMI grade III flow in the infarct-related artery (IRA) before primary PCI) in patients with AMI, implying the potential relationship between HHcy with less early IRA patency. However, to our knowledge, there is no detailed study evaluating the relationship between plasma tHcy levels and SCF measured by mean CTFC in patients with AMI.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Relationship Between Plasma Total Homocysteine Levels and Mean Corrected TIMI Frame Count in Patients with Acute Myocardial Infarction

Hu¹,

Lü²,

Huang³

et al. 2021

IJGM

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Relationship Between Plasma Total Homocysteine Levels and Mean Corrected TIMI Frame Count in Patients with Acute Myocardial Infarction

Hu¹,

Lü²,

Huang³

et al. 2021

IJGM

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“…The pathogenesis of CSF still is not clear, and it is mostly considered to be related to coronary atherosclerosis, endothelial dysfunction, chronic inflammatory response, oxidative stress response, microvascular dysfunction, and abnormal platelet function ( Li et al, 2019 ; Henein and Vancheri, 2021 ; Zhu and Su, 2021 ). SXBXP is a modified formula of Su He Xiang Pill derived from Taiping Huimin Heji Ju Fang in the Song Dynasty and it is indicated for the chest painful impediment syndrome with pattern of Qi stagnation and blood stasis.…”

Section: Discussionmentioning

confidence: 99%

Meta-analysis and trial sequential analysis of shexiang baoxin pill for coronary slow flow

Guo

Zhu

2022

Front. Pharmacol.

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Background: Coronary slow flow (CSF) is a common cardiovascular phenomenon with no effective treatment in conventional Western medicine (CWM). Shexiang Baoxin Pill (SXBXP) is a widely used Chinese medicine for cardiovascular disease in China, and clinical studies have shown that it has good efficacy for CSF.Objective: To systematically evaluate the efficacy and safety of SXBXP for CSF.Methods: Seven databases were searched to identify related randomized controlled trials (RCTs). The Meta-analysis, trial sequential analysis (TSA), and Grades of Recommendation, Assessment, Development and Evaluation (GRADE) were performed using Stata 14.1, TSA 0.9.5.10 Beta and GRADE profiler 3.2.2 software respectively.Results: A total of 10 RCTs were included. Meta-analysis showed that compared with CWM treatment alone, SXBXP combined with CWM further improved the angina pectoris efficacy [RR = 1.37, 95% CI (1.23, 1.52), p < 0.000 01] and nitric oxide (NO) level [WMD = 11.32, 95% CI (0.04, 22.59), p = 0.049], decreased the mean corrected TIMI frame count (CTFC) [WMD = −4.23, 95% CI (−5.51, −2.95), p < 0.000 01], CTFC of the left anterior descending artery (LAD) [WMD = −6.36, 95% CI (−12.07, −0.65), p = 0.029], left circumflex artery (LCX) [WMD = -5.73, 95% CI (−8.79, −2.67), p < 0.000 01], and right coronary artery (RCA) [WMD = −6.72, 95% CI (−10.60, −2.84), p = 0.001], decreased the positive rate of treadmill exercise test [RR = 0.45, 95% CI (0.25, 0.83), p = 0.010], endothelin-1 (ET-1) level [WMD = -11.03, 95% CI (−13.92, −8.14), p < 0.000 01], high-sensitivity C-reactive protein (hs-CRP) [WMD = −1.95, 95% CI (−2.57, −1.34), p < 0.000 01], and adverse reactions [RR = 0.20, 95% CI (0.05, 0.85), p = 0.030]. The GRADE evidence quality rating presented with moderate, low or very low quality of evidence. TSA further affirmed the clinical efficacy.Conclusion: Although some results suggest that there may be a positive effect of SXBXP for CSF, the quality of the primary study including the reporting is too poor and therefore, no benefits could be demonstrated. More high-quality studies are still needed to further confirm the efficacy and safety.Systematic review registration:https://www.crd.york.ac.uk/PROSPERO/, identifier (CRD42022329469).

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“…Elevated homocysteine levels were associated with an increased risk of serious adverse cardio-vascular events and overall mortality among patients with acute coronary syndrome (43). Studies have also shown a positive correlation between hyperhomocysteinemia and the coronary slow flow phenomenon (CSFP) and cardiovascular adverse events (44). Elevated homocysteine levels also represent the independent risk factor for congestive heart failure in adults without myocardial infarction in the history of the disease: the risk was 1.9 times higher in men and 1.8 times higher in women (45).…”

Section: Hyperhomocysteinemia and Cardiovascular Diseasesmentioning

confidence: 99%

Current knowledge on the prevention of hyperhomocysteinemia as a risk factor for cardiovascular diseases

Miladinović¹,

Živković²,

Kitić³

et al. 2023

Acta fac medic Naissensis

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Introduction. Homocysteine is an amino acid that is formed in the metabolism of methionine as the quantitatively most important metabolite. Its chemical structure has been known for 90 years and its biological roles are still being investigated. Under normal conditions, homocysteine is present in plasma at the concentration of 5 - 9 mmol/l. When the cell capacity for homocysteine is reached, it is transported to the extracellular space, until the intracellular level is normalized. If the cell is unable to reach the required levels of homocysteine, it accumulates in the blood and hyperhomocysteinemia occurs. Discussion. It has been determined that many factors, such as congenital enzyme deficiency, age, sex, inadequate diet (vitamin B complex deficiency) increase the level of homocysteine in the blood. Impaired kidney function, diabetes, hyperthyroidism, as well as many medications, can have an effect on homecysteinemia. Increased concentration of homocysteine in the blood accelerates the process of atherosclerosis by several different mechanisms and represents an independent risk factor for the occurrence of cardiovascular diseases and adverse cerebral events. The prevalence of hyperhomocysteinemia is estimated at 5% in the general population and 13 - 47% among patients with symptomatic atherosclerotic vascular disease. Conclusion. For these reasons, the level of homocysteine in the blood should be monitored and corrective measures should be implemented, which include sufficient intake of folic acid, vitamins B12 and B6, in doses that depend on fasting homocysteine levels and after the methionine load test.

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Evaluation of Homocysteine in the Diagnosis and Prognosis of Coronary Slow Flow Syndrome

Cited by 11 publications

References 15 publications

Relationship Between Plasma Total Homocysteine Levels and Mean Corrected TIMI Frame Count in Patients with Acute Myocardial Infarction

Relationship Between Plasma Total Homocysteine Levels and Mean Corrected TIMI Frame Count in Patients with Acute Myocardial Infarction

Meta-analysis and trial sequential analysis of shexiang baoxin pill for coronary slow flow

Current knowledge on the prevention of hyperhomocysteinemia as a risk factor for cardiovascular diseases

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