Homocysteine and fibrinolysin in elderly patients with coronary heart disease

Zhe CHEN; Jian ZHANG; Chunshen LI; Baosen PANG; Xifeng LIU

ABSTRACT

BACKGROUND:

Homocysteine(HCY) is emerging as an independent risk factor for atherosclerosis. Its damage to the structure and function of endothelial cell(EC) is seemingly an important mechanism that leads to atherosclerosis.

OBJECTIVE:

To investigate the effect of HCY on fibrinolysis in elderly patients with coronary heart disease(CHD).

DESIGN:

A case-controlled study based on CHD patients and normal people as control group.

SETTING:

Department of general internal medicine and department of cardiology in a university hospital.

PARTICIPANTS:

The study was completed in the Department of Gerontology Internal Medicine and Department of Cardiology, Beijing Chaoyang Hospital, Capital University of Medical Science. Altogether 177 inpatients and outpatients from this hospital during December 2001 to August 2003 were selected and divided into three groups according to the results of coronary angiography(CAG) CHD group( n = 91 ) with 50 males and 41 females with the mean age of(66 ± 6) years, negative CAG group( n = 86) with 43 males and 43 females with the mean age of(60 ± 6) years, and normal control group( n = 85) with 43 healthy males and 42 healthy females with the mean age of(55± 5) years.

METHODS:

Peripheral blood samples were collected. ELISA double antibody method was applied to test tissue-type plasminogen activator(t-PA), plasminogen activator inhibitor-1 (PAI-1) and yon Willebrand factor(vWF). HCY was assayed with EIA method and the ratio of PAI-1 to t-PA was calculated.MAIN OUTCOME

MEASURES:

HCY level, t-PA, PAI-1 and vWF activities, and the ratio of PAI-1 to t-PA.

RESULTS:

The levels of HCY, PAI-1, PAI-1/t-PA and vWF in CHD group were significantly higher than those in negative CAG group and normal control group( P ＜ 0.01 ); however, the level of t-PA was significantly lower than that in control group( P ＜ 0. 01) . HCY was positively correlated with PAI-1,PAI-1 / t-PA and vWF, while it was negatively correlated with t-PA.

CONCLUSION:

The increase of serum HCY is accompanied with fibrinolytic dysfunction. HCY is positively correlated with PAI-1 and vWF but negatively correlated with t-PA. Therefore, HCY is a predictor for early coronary lesions,and can provide related laboratory data for the primary prevention and early treatment of CHD.