Analysis of the association and predictive value of hyperhomocysteinaemia for obstructive coronary artery disease

J Int Med Res. 2021 Jul;49(7):3000605211033495. doi: 10.1177/03000605211033495.

Abstract

Objective: To investigate the predictive value of hyperhomocysteinaemia (HHcy) for obstructive coronary artery disease (CAD) in an Asian population in northern China.

Methods: This retrospective study enrolled patients at their first cardiac assessment and assigned them to an obstructive CAD group or a non-obstructive CAD group according to the coronary angiography results. HHcy was defined as a homocysteine (Hcy) level > 15 µmol/l.

Results: This study enrolled 2987 participants: 1172 in the non-obstructive CAD group and 1815 in the obstructive CAD group. Hcy level in the obstructive CAD group was significantly higher than in the non-obstructive CAD group. The proportion of patients with HHcy in the obstructive CAD group was significantly greater than in the non-obstructive CAD group. Multivariate logistic regression analysis demonstrated that HHcy was independently correlated with obstructive CAD in both young (aged ≤ 55 years) and old patients (aged > 55 years). HHcy showed a higher sensitivity (93.1%), specificity (86.1%) and accuracy (90.0%) for obstructive CAD. The odds ratio for HHcy was 84.2. The Kappa value (0.8) showed substantial agreement between obstructive CAD and HHcy.

Conclusions: HHcy was associated with obstructive CAD and may be a potentially independent risk factor for obstructive CAD with good predictive value.

Keywords: Coronary artery disease; homocysteine; hyperhomocysteinaemia; northern China; risk prediction.

MeSH terms

  • China
  • Coronary Angiography
  • Coronary Artery Disease* / diagnostic imaging
  • Homocysteine
  • Humans
  • Hyperhomocysteinemia* / complications
  • Hyperhomocysteinemia* / diagnosis
  • Retrospective Studies
  • Risk Factors

Substances

  • Homocysteine