1.Relationship between hyperhomocysteine and long-term outcome of coronary artery disease patients after drug-eluting stent implantation.
Gaoliang YAN ; Dong WANG ; Yong QIAO ; Wenjie KONG ; Xiang SHA ; Tianyu CHENG ; Hairong ZHANG ; Jiantong HOU ; Chengchun TANG ; Email: TANGCHENGCHUN@MEDMAIL.COM.CN. ; Genshan MA
Chinese Journal of Cardiology 2015;43(11):943-947
OBJECTIVETo explore the relationship between hyperhomocysteinemia (H-Hcy) and long-term outcome of coronary artery disease (CAD) patients after drug-eluting stent (DES) implantation in a single centre.
METHODSA total of 1 408 consecutive patients implanted with DES in our department between March 2011 and January 2013 were enrolled in this prospective study. Patients were stratified into H-Hcy (Hcy≥10 µmol/L, n=798, 56.7%) and non-H-Hcy group (Hcy<10 µmol/L, n=610, 43.3%). The clinical characteristics, coronary artery lesions, SYNTAX score and 1-year major adverse cardiac and cerebrovascular events (MACCE) were compared between the two groups.
RESULTSCompared with non-H-Hcy group, coronary artery stenosis was severer as shown by higher diseased arteries (2.11±0.87 vs. 1.91±0.82, P<0.001), higher incidence of three diseased arteries (39.7% vs. 29.5%, P<0.001) and higher SYNTAX score (36.99±29.66 vs. 27.39±22.70, P=0.001) in H-Hcy group. The 1-year incidence of MACCE was also higher in H-Hcy group compared with non-H-Hcy group(18.4% vs. 8.9%, P<0.001). Multivariate Cox analysis showed that diabetes mellitus (OR=1.530, 95%CI 1.142-2.050, P=0.004), age (OR=1.065, 95%CI 1.038-1.093; P<0.001), and Hcy (OR=1.019, 95%CI 1.005-1.033, P=0.009) are the independent predictors for 1-year MACCE.
CONCLUSIONHigh Hcy level is correlated with the severity of coronary artery stenosis, and serves as an independent predictor of MACCE after stenting in CAD patients.
Coronary Artery Disease ; Drug-Eluting Stents ; Homocysteine ; Humans ; Prospective Studies ; Time Factors ; Treatment Outcome
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