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To investigate the effect of serum homocysteine level on prognosis of patients suffering from acute non-ST segment elevated myocardial infarction (NSTEMI).
A total of 307 patients suffering from acute NSTEMI diagnosed in Shengjing Hospital of China Medical University from December 1 2012 to October 31 2014 were enrolled for the study. All patients underwent process of percutaneous coronary artery intervention immediately or during hospitalization. Then the patients were divided into normal homocysteine level group (N-Hcy group: n=190) and high homocysteine level group (H-Hcy group: n=117) according to the serum homocysteine level on admission. The effect of serum homocysteine level on the prognosis was then analyzed by the COX regression analysis.
Compared with the N-Hcy group, the patients of the H-Hcy group have a higher proportion of male and are with a higher ratio of stroke in the past. The proportion of smoker is larger. The patients classified as Killip III/IV stage are more common, and are with higher Gensini score and more frequent application of intra-aortic balloon pumping as well. Post-operation follow-up shows that patients of H-Hcy group have a higher incidence of all-cause mortality and cardiac mortality. No significant difference can be found between the two groups on the occurrence of nonfatal myocardial infarction and unplanned repeat revascularization. Multivariate COX analysis shows significant predictive value of patients with NSTEMI after correction of various clinical factors.
Serum homocysteine level can be considered as a predictor of prognosis on patients with NSTEMI, for post-operation follow-up showing prognostic significance in both all-cause death and cardiac death.