Effect of plasma homocysteine on central arterial pressure and major adverse cardiac cerebrovascular events in patients with coronary heart disease
Objective To explore the effect of plasma homocysteine(Hcy)on central arterial pressure(CAP)and major adverse cardiac cerebrovascular events(MACCE)in patients with coronary heart disease(CHD).Methods 115 patients with CHD confirmed by coronary angiography were divided into normal Hcy group(Hcy≤15 μmol/L,66 cases)and high Hcy group(Hcy>15 μmol/L,49 cases)according to different plasma Hcy level,and the clinical data of the two groups were compared.The correlation between plasma Hcy and blood pressure[central artery systolic pressure(CASP),central artery diastolic pressure(CADP),central artery pulse pressure(CAPP),systolic blood pressure(SBP),diastolic blood pressure(DBP),and pulse pressure(PP)]was analyzed.The Kaplan-Meier method was used to draw patient survival curves and analyze the survival prognosis of CHD patients under the influence of different factors;the COX regression model was used to analyze the risk factors for MACCE in CHD patients.Results In the high Hcy group,the percentage of hypertension,the percentage of lesions with two or more branches,the blood uric acid,Hcy,CASP,CADP,CAPP,SBP and DBP were 71.43%,(345.10±95.22)μmol/L,(20.37±3.72)μmol/L,and(140.08±20.17)mm Hg(1 mm Hg=0.133 kPa),(83.22±11.83)mm Hg,(56.86±14.17)mm Hg,(137.18±20.41)mm Hg and(84.14±13.19)mm Hg,which were higher than 43.94%,45.45%,(307.79±77.36)μmol/L,(10.69±2.76)μmol/L,(123.83±18.01)mm Hg,(77.61±9.51)mm Hg,(46.23±14.72)mm Hg,(127.67±17.45)mm Hg and(77.47±10.84)mm Hg in the normal Hcy group(P<0.05).Pearson correlation analysis showed that plasma Hcy was positively correlated with CASP(r=0.331,P=0.000<0.001),CADP(r=0.291,P=0.002<0.05),CAPP(r=0.237,P=0.011<0.05),SBP(r=0.259,P=0.005<0.05)and DBP(r=0.324,P<0.001).There was no correlation between plasma Hcy and PP(r=0.100,P=0.290>0.05).Kaplan-Meier survival curve analysis showed that patients with high Hcy level,CAPP≥50 mm Hg and PP≥52 mm Hg had an increased risk of MACCE(χ2=6.714,8.741,4.594;P=0.010,0.003,0.032<0.05).Multivariate COX regression analysis showed that diabetes mellitus and CAPP were independent risk factors for the development of MACCE in CHD patients(P<0.05).Conclusion Plasma Hcy is closely related to CAP levels,and CAPP and diabetes are independent risk factors for the development of MACCE in CHD patients.
万方数据
维普
