Study on correlation between plasma homocysteine level and prognosis in patients with acute myocardial infarction / 重庆医学

ABSTRACT

Objective To investigate the correlation between plasma homocysteine(Hcy) and long term occurrence of main adverse cardiac events(MACE) in the patients with acute myocardial infarction(AMI).Methods A total of 326 inpatients with AMI in the cardiology department of this hospital from Mar.2012 to Dec.2014 were continuously included.The related laboratory biochemical indicators such as Hcy were detected according to the standard flow process by the hospital clinical laboratory department.The Hcy level and MACE occurrence rate were performed the receiver operating characteristic(ROC) curve analysis.The research subjects were divided into the Hcy(L) group and Hcy(H) group according to the cut-off value 11.69μmol/L.The base line data of all subjects were collected and the follow up was conducted for recording MACE.Results The plasma N-terminal pro-brain natriuretic peptide (NT-ProBNP) level in the Hcy(L) group was significantly lower than that in the Hcy(H) group[-(501.46-±-118.35)pg/mL vs.(1 324.11 ± 523.13) pg/mL,P =0.02],while the left ventricular ejection fraction(LVEF) was significantly higher than that in the Hcy(H) group[(55.23 ± 9.48) ％ vs.(50.79 ± 10.68) ％,P =0.03].After 1-year follow up,LVEF in the Hcy(H) group was significantly decreased compared with the base line [(45.32±10.18)％ vs.(50.79±10.68)％,P＜0.05],moreover the MACE occurrence risk in the Hcy(H) group was significantly higher than that in the Hcy(L) group,the difference after correcting the related confounding factors had statistical significance (P=0.048),but LVEF and minor axis shortening rate of left ventricle(FS) in the Hcy(L) group had no obvious difference compared with the base line data[(54.43 ± 10.68)％ vs.(55.23± 9.48) ％,(28.56±6.21) ％ vs.(29.22±5.30) ％,P＞0.05].Conclusion The risk of long term MACE occurrence in the patients with AMI complicating plasma high Hcy level is obviously increased compared with that in the patients with plasma low Hcy level and the prognosis is poor,prompting that plasma high Hcy level is one of possible independent predicting factors for poor prognosis in the patients with AML But its action mechanism and whether the Hcy interventional therapy improving prognosis of AMI patients still need to further study.