| Objective:The purpose of this study is to review the correlation of serum homocysteine to the complexity of coronary artery disease,and to explore the correlation between serum homocysteine and coronary artery disease and effect of serum homocysteine on the prognosis of different revascularization by the follow-up of patients after different revascularization.Methods:1.We collected 230 patients who underwent coronary angiography from June 2015 to July 2017 in our hospital,and scored SYNTAX and SYNTAX II according to the angiographic condition.2.According to the level of homocysteine,the patients with homocysteine of the serum homocysteine(≥15mol/l)were set as the observation group according to the international definition of high serum homocysteine,and the patients with homocysteine <15mol/l were set as the control group.The effects of serum homocysteine on coronary artery lesion were compared.3.All the patients underwent operation according to SYNTAX II score and clinical consideration.They were divided into PCI group and CABG group according to different revascularization methods.The incidence of MACE events was compared between the observation group and the control group in different groups.Results:1.The number of multiple coronary artery targets and SYNTAX scores in the coronary artery of the observation group were significantly higher than those in the control group,the difference was statistically significant(P<0.05).The correlation coefficient of serum homocysteine level was correlated with the Sperman correlation analysis,the correlation coefficient was r=0.35,P<0.05.Logistic regression analysis showed that fasting blood glucose and homocysteine were independent of SYNTAX scores after correction of factors such as age,sex,serum creatinine and ejection fraction.The value of OR was 2.685,2.998,and P < 0.05,respectively.2.The average follow-up of group PCI was 17.43 + 7.1 months.There were 33 cases of MACE event,21 cases(45.6%)of MACE event in high HCY group which were higher than that of the control group MACE event(24%),and differences are statistically significan.The average follow-up time of CABG group was 16.62 + 5.7 months after operation.A total of 16 patients had MACE events,there were 8 cases(18.1%)of high HCY group MACE event,8 cases(16%)of MACE event in the control group,and chi square test P=0.791,lack of statistical significance.3.The COX regression survival analysis showed that the incidence of MACE events in the PCI operation group was significantly higher than that in the control group,and logrank test P = 0.038,which was statistically significant.Compared with the control group,the incidence of MACE events in the CABG operation group was significantly lower than that in the control group(logrank test P = 0.544).Conclusion:The level of serum homocysteine in patients with coronary heart disease is associated with the severity of coronary artery disease and is an independent risk factor for coronary artery disease.The incidence of MACE in CABG patients with hyperhomocysteinemia is lower than that in patients undergoing PCI.Homocysteine had a higher impact on MACE events after PCI than CABG. |
