Correlation Of Homocysteine,Lipoprotein(a) And Degree Of Coronary Artery Lesion In Postmenopausal Female With Coronary Heart Disease

Objective: To investigate the relationship between serum homocysteine and lipoprotein(a)levels in postmenopausal female with coronary heart disease(CHD),and explore the correlation between homocysteine,lipoprotein(a)and the degree of coronary artery disease in postmenopausal female with CHD。Methods: A total of 240 postmenopausal female patients with suspected CHD were selected from January 2020 to December 2020 at the Second Hospital of Hebei Medical University.According to the results of coronary angiography,120 postmenopausal women with coronary artery stenosis ≥50% were included in the coronary heart disease group.118 postmenopausal women with coronary stenosis less than 50% during the same period were included in the control group.According to the Gensini score,the CHD group was divided into three groups with mild(n=63)moderate(n=30)and severe lesions(n=27).The general clinical data and the levels of homocysteine and lipoprotein(a)in each group were compared to analyze the correlation with the degree of CHD.Results:1.Compared with the control group,the history of diabetes and the levels of LVEF,Hcy,TG,TC,LDL-C and LP(a)were higher in the CHD group,while the level of HDL-C was lower,with statistical significance.2.There was no significant difference in the level of Hcy among different Gensini score groups(P>0.05).The levels of Lp(a)in different Gensini score groups were more severe than moderate than mild.The difference between the mild disease group and the severe disease group was statistically significant.3.Correlation analysis was conducted between Gensini score and Hcy and Lp(a)in the CHD group.Hcy(r=0.205),Lp(a)(r=0.248)were positively correlated with Gensini score,and the difference was statistically significant.4.Logistic regression analysis showed that history of diabetes,Hcy,TC,LP(a)were positively correlated with CHD(B value was 1.170,0.100,1.195,0.031,P < 0.05),while HDL-C was negatively correlated with CHD(B value was-1.856,P < 0.05).5.The ROC curve was drawn: the area under the curve corresponding to Hcy was 0.596(95%CI:0.522-0.667,P<0.05).The sensitivity and specificity for predicting CHD were 58.3% and 64.4% respectively.The area under the curve corresponding to Lp(a)was 0.699(95%CI:0.632-0.766,P<0.05).The sensitivity and specificity for predicting CHD were 69.2% and 70.3%respectively.Conclusions:1.Hcy and Lp(a)are risk factors of coronary heart disease in postmenopausal female。2.Hcy was positively correlated with Gensini score,but there was no significant difference in Hcy level among different Gensini score groups,suggesting that Hcy may be associated with the severity of coronary artery disease in postmenopausal female.3.Lp(a)was positively correlated with Gensini score,and Lp(a)was associated with the severity of coronary artery disease in postmenopausal female。4.Early detection of Hcy and Lp(a)levels in postmenopausal female has predictive value for the diagnosis of CHD.