Correlation of serum Hcy level with coronary artery disease in patients with normal hsCRP

Abstract

Objective To observe and analyze the relationship between serum Hcy concentration and coronary artery disease (CAD) in patients with normal high-sensitivity C-reactive protein (hsCRP) level. Methods A total of 4 097 patients (2 787 males and 1 310 females) who underwent coronary angiography and had hsCRP ≤2.0 mg/L in the Department of Cardiology, First Affiliated Hospital of Xi'an Jiaotong University from April 2017 to April 2019 were enrolled in this study. According to serum Hcy level in the tertile, they were divided into high, middle and low level groups (>19.40, >13.90~19.40, ≤13.90 μmol/L). The differences in baseline data and clinical biochemical parameters were compared among the groups. Logistic regression analysis was used to evaluate the relationship between Hcy concentration with CAD prevalence and severity. Results The severity of CAD was more serious in the high Hcy group than the low Hcy group (Gensini score: 35.39±33.95 vs 26.25±27.04, P < 0.001), and the serum Hcy level was significantly positively correlated with the Gensini score (r=0.122, P < 0.001). The incidence rates of acute myocardial infarction (15.2% vs 9.2%, P < 0.001) and three-vessel disease (34.8% vs 29.0%, P=0.004) were significantly higher in the high Hcy group than low Hcy group. Logistic regression analysis showed that after adjustment for all baseline differences, serum Hcy level was still positively correlated with the prevalence (P=0.006) and severity (P=0.002) of CAD and the incidence of acute myocardial infarction (P=0.001). Conclusion Serum Hcy may be an independent predictor of CAD prevalence and severity in patients with normal hsCRP level.

Keywords

• coronary angiography
• coronary stenosis
• high-sensitivity c-reactive protein
• homocysteine