Relationship Between Plasma Hyperhomocysteine And Intima-media Thickness Of Carotid Artery In Patients With Coronary Heart Disease: A Meta Analysis Of Randomized Controlled Trials

Objective To investigate the relationship between plasmahyperhomocysteine (Hcy) and intima-media thickness (IMT) of carotidartery in patients with coronary heart disease（CHD）， to further clarify therisk factors of CHD and (or) prediction index, to provide theoretical andpractical support for its diagnosis and treatment.Method We searched the electronic databases from inception to April102014for public published randomized controlled trials evaluating therelationship between plasma Hcy and IMT of carotid artery in patients withCHD. The quality of trials was evaluated by title and abstract of literatureaccording to the eligibility criteria. If the clinical RCTs conformed to theinclusive criteria without the exclusive criteria items, they would be enrolledin this meta-analysis. We conducted the meta-analysis of the data collectedfrom the included studies with the software of review manager5.1.Results11randomized clinical control studies were included in themeta analysis, and plasma Hcy was compared in CHD group and controlgroup in the literature, also including5studies that IMT of carotid arterywas further measured by Doppler ultrasound in CHD group. The NOS scorerevealed that the quality of the included studies was good. Meta analysis on relationship between plasma Hcy and CHD by fixed effect model showedthat plasma Hcy of CHD group was higher than that of controlgroup[WMD=5.10，95%CI (4.57，5.50), P<0.00001], and it suggestedthat plasma Hcy had relationship with CHD. The sensitivity analysisconfirmed that the statistical heterogeneity related with the low qualityliterature, but the former positive results didn’t reversed by the new metaanalysis after excluding low quality literature, and sensitivity analysisconfirmed that the result was stable and reliable. Meta analysis onrelationship between plasma Hcy and IMT of carotid artery in patients withCHD by fixed effect model showed that they had relationship betweenplasma Hcy and IMT of carotid artery in patients with CHD, and there wasstatistical difference [WMD=5.76, P<0.00001].Conclusion Plasma Hcy had relationship with CHD, and the plasmaHcy level is higher in IMT thickened group of CHD, and they haverelationship between plasma Hcy and IMT of carotid artery in patients withCHD, so it suggests that higher plasma Hcy level is an important andindependent risk factor for CHD, so it has important on prevention of CHDand intervention by the detection of plasma Hcy level.