Objective To explore the evaluation value of detection of serum homocysteine (Hcy) combined with coronary calcium score (CCS) for short-term prognosis in patients with acute coronary syndrome (ACS).
Methods A total of 180 hospitalized patients with coronary heart disease were selected as research objects, and were divided into the ACS group (84 cases) and the stable angina pectoris (SAP)(96 cases) according to the severity of the disease.According to the incidence of major adverse cardiovascular events (MACE) during the follow-up period of 12 months, ACS patients were divided into event sub-group (n=36) and non-event sub-group (n=48).CCS, serum Hcy, high-sensitivity C-reactive protein (hs-CRP), low-density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c) of patients in two groups were compared.The correlation between CCS and serum Hcy level in ACS patients was analyzed.The main risk factors of MACE in ACS patients were analyzed after 12 months of follow-up.The value of CCS and serum Hcy level in predicting prognosis of ACS patients at 12 months follow-up was evaluated by receiver operating characteristic (ROC) curve.
Results The serum levels of Hcy, hs-CRP, LDL-C, FPG and HbA1c in the ACS group were significantly higher than those in the SAP group, while the CCS was significantly lower than that in the SAP group (P < 0.05).CCS was negatively correlated with serum Hcy level in ACS patients (P < 0.05).The CCS of ACS patients in the event sub-group was significantly lower than that in the non-event sub-group, and the serum Hcy level was significantly higher than that in the non-event sub-group (P < 0.05).Serum Hcy was a risk factor for MACE in ACS patients followed up for 12 months (OR=2.872, P=0.020), and CCS was a protective factor (OR=0.459, P=0.011).The cut-off value of serum Hcy was 21.5 μmol/L, and the cut-off value of CCS was 410.0, the area under the curve (AUC) of joint prediction was 0.822, the sensitivity was 86.3%, and the specificity was 80.6%.
Conclusion The combination of CCS and serum Hcy level has good accuracy in evaluating the short-term outcome of ACS patients.
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