The Association between Serum Homocysteine to High-Density Lipoprotein Cholesterol Ratio and Premature Coronary Heart Disease

Yuyun YOU; Yunfei HONG; Xia ZHENG; Feifei LIU; Jinsong YIN

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Yuyun YOU, Yunfei HONG, Xia ZHENG, Feifei LIU, Jinsong YIN. The Association between Serum Homocysteine to High-Density Lipoprotein Cholesterol Ratio and Premature Coronary Heart Disease[J]. Journal of Kunming Medical University.

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The Association between Serum Homocysteine to High-Density Lipoprotein Cholesterol Ratio and Premature Coronary Heart Disease

1.
Dept. of Medical Imaging，Kunming Municipal Hospital of Traditional Chinese Medicine，Kunming Yunnan 650051
2.
Dept. of Cardiology，The 3rd People’s Hospital of Yunnan Province/The 2nd Affiliated Hospital of Dali University，Kunming Yunnan 650011，China

Received Date: 2024-04-09
Available Online: 2024-10-08

Abstract

Abstract

Objective To evaluate the predictive value of changes in serum homocysteine （Hcy）, high-density lipoprotein cholesterol （HDL-C）, and the homocysteine-to-HDL-C ratio （HHR） for the incidence and short-term prognosis of patients with premature coronary heart disease （PCHD）. Methods Between January 2022 and December 2023, 301 patients with suspected coronary heart disease （males ≤ 55 years, females ≤ 65 years） were retrospectively selected from the Department of Cardiology at the Third People’ s Hospital of Yunnan Province. All patients who underwent coronary angiography （CAG） were divided into two groups: the premature coronary heart disease （PCHD） group （n 98） and the non-coronary heart disease （NCHD） group （n 203）. Patients with PCHD were followed up six months after the discharge and were further classified into the good prognosis group （n 55） and the poor prognosis group （n 43） based on the presence of worsening clinical symptoms such as chest tightness, chest pain, arrhythmias, heart failure, or death. Data collected included general patient information, blood lipid levels, Hcy levels, left ventricular function ultrasound indicators, and the presence of hypertension and type 2 diabetes. Results Hcy and HHR levels were significantly higher in the PCHD group compared to the NCHD group, while HDL-C levels were lower （P < 0.001）. In the poor prognosis group, Hcy and HHR levels were elevated, and HDL-C levels were reduced compared to the good prognosis group （P < 0.001）. The Hcy and HHR levels in the severe coronary artery stenosis group were markedly higher than those in the normal coronary artery group and the mild to the moderate stenosis group, with HDL-C levels being lower （P < 0.001）. Multivariate logistic regression analysis identified that male sex, HHR, Hcy, low-density lipoprotein cholesterol （LDL-C）, and left ventricular ejection fraction （LVEF） were independent factors influencing premature coronary heart disease （P < 0.05）. HHR was found to be an independent risk factor for poor short-term prognosis in PCHD. The analysis of the operating characteristic curve of the subjects showed that serum Hcy and HHR had the predictive value for the occurrence of PCHD （P < 0.05）, with HHR showing higher predictive value （area under the curve [AUC] = 0.713）. HHR also had the substantial predictive value for the short-term prognosis of PCHD （AUC = 0.715）. Conclusion Elevated HHR levels are associated with severe coronary artery disease in patients with PCHD. HHR serves as a significant predictor for both the occurrence and short-term prognosis of PCHD.

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References(25)

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