Blood homocysteine levels could predict major adverse cardiac events in patients with acute coronary syndrome

Abstract

The Global Registry of Acute Coronary Events (GRACE) risk score independently predicts major adverse cardiac events (MACEs) in patients with acute coronary syndrome (ACS). This study aims to evaluate whether the level of plasma homocysteine in addition to the GRACE score enhances the predictive value for MACEs in patients with acute coronary syndrome.A total of 361 patients with ACS evaluated at our hospital were included in the study and tested for blood homocysteine levels. We recorded 40 (11.1%) instances of MACE during a median follow-up of 43.3 months (quartile 40.6–44.4 months), including 29 cases (8.0%) of all-cause death and 11 cases (3.1%) of nonfatal myocardial infarction.The GRACE score was significantly associated with homocysteine levels, and multivariate Cox regression analysis showed that both the GRACE risk score and homocysteine content were independent predictors of MACEs (HR 2.63; 95% confidence interval (CI) 1.54 to 4.49; P < .001 and 2.27; 1.06 to 4.86; P = .035, respectively). Moreover, meta-analysis showed that as the homocysteine level increased, the incidence of MACEs also increased (log-rank 8.41; P = .015). GRACE scores adjusted by homocysteine level increased the area under the curve (AUC) from 0.78 to 0.83 (P = 0.006).Blood homocysteine levels are significantly associated with the GRACE risk score, and using both parameters can further improve risk stratification in patients with acute coronary syndrome.

Homocysteine level, body mass index and clinical correlates in Chinese Han patients with schizophrenia

“…Other demographic and clinical factors such as diet habits, physical activity, drug treatment, chronic inflammation or the methods of measuring Hcy may also be implicated in the these inconsistent results. Interestingly, we found that Hcy was negatively associated with BMI in schizophrenia, which was inconsistent with most of previous studies showing that high Hcy may be related to obesity and increase the risk of coronary heart disease 33 , 34 . This may be attributed to the effects of different diseases, different stages of disease development 18 , or medication treatment regiments 35 .…”

“…Correlation analysis showed that HCY levels were negatively associated with BMI. www.nature.com/scientificreports/ disease 33,34 . This may be attributed to the effects of different diseases, different stages of disease development 18 , or medication treatment regiments 35 .…”

The design of a homocysteine fluorescent probe based on Rhodamine B and its responsiveness in the serum of cerebral infarction patients�

“…Some developed and developing countries, including China, the United States and Japan have large and rapidly aging populations. Hcy is an important diagnostic marker for cerebral infarction (15); therefore, it is of great importance to develop an effective Hcy detection method with potentially beneficial values in clinical applications.…”

Folic Acid Supplementation in Patients with Elevated Homocysteine Levels

“…Elevations in plasma Hcy levels are often multifactorial, with genetic and acquired components [ 54 ]. While the correlation between hyperhomocysteinemia and vascular disease is well established [ 55 – 57 ], the underlying mechanisms are under investigation. Animal and cell models have highlighted the potential mechanisms for Hcy-mediated damage to the vascular architecture, but evidence of a causal relationship between hyperhomocysteinemia and vascular disease in humans remains to be shown [ 58 ].…”