Key result
High serum homocysteine levels were associated with a significantly higher 1-year incidence of MACCE compared to normal levels (15.1% vs. 9.5%; P=0.042) after drug-eluting stent implantation.
Why the study?
To determine the effect of high homocysteine levels on coronary artery disease severity and prognosis after stent implantation.
Does a high serum homocysteine level increase the severity of coronary artery disease and the incidence of MACCE in patients undergoing first-time drug-eluting stent implantation?
Cohort (n=667)
No
Does a high serum homocysteine level increase the severity of coronary artery disease and the incidence of MACCE in patients undergoing first-time drug-eluting stent implantation?
Absolute Event Rate: 15.1% vs 9.5%
p-value: p=0.042
High serum homocysteine levels are associated with more severe coronary artery disease and independently predict an increased risk of MACCE at 1 year following first-time drug-eluting stent implantation.
High homocysteine may flag elevated post-DES MACCE risk; leaves open whether lowering levels improves outcomes.
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.
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Li et al. (2020) conducted a cohort in Coronary heart disease (n=667). High homocysteine (H-HCY) levels vs. Control (normal homocysteine levels) was evaluated on Major adverse cardiovascular and cerebrovascular events (MACCE) (p=0.042). High serum homocysteine levels were associated with a significantly higher 1-year incidence of MACCE compared to normal levels (15.1% vs. 9.5%; P=0.042) after drug-eluting stent implantation.
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