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Observational Study
. 2018 Jun 25;18(1):125.
doi: 10.1186/s12872-018-0868-3.

Admission homocysteine is an independent predictor of spontaneous reperfusion and early infarct-related artery patency before primary percutaneous coronary intervention in ST-segment elevation myocardial infarction

Jing Li  1 , Ying Zhou  2 , Yaowen Zhang  3 , Jingang Zheng  2
Affiliations
Observational Study

Admission homocysteine is an independent predictor of spontaneous reperfusion and early infarct-related artery patency before primary percutaneous coronary intervention in ST-segment elevation myocardial infarction

Jing Li et al. BMC Cardiovasc Disord. .

Abstract

Background: Spontaneous reperfusion (SR) and early infarct related artery (IRA) patency before primary percutaneous coronary intervention (PPCI) might bring extra benefit for patients with ST-segment elevation myocardial infarction (STEMI). This study premilinarily screened the independent predictors of SR, and assessed the relationship between SR and plasma homocysteine (HCY).

Methods: The medical records of 998 patients who were diagnosed as STEMI and underwent emergency coronary angiography were retrospectively studied, SR was defined as achievement of TIMI grade 3 flow in the IRA before PCI. The baseline characteristics, clinical manifestations and hematological variables were compared between SR and NSR group. Optimal cutoff point of HCY was calculated with receiving operating characteristics (ROC) analysis, multivariate logistic regression models were used to identify predictors of SR.

Results: 229 (22.95%) patients showed angiographic SR. For HCY, the area under the curve was 0.70 (95% CI: 0.63-0.77, P = 0.034), the optimized cut off point was 17.55 μmol/L. Preinfarct angina (95% CI: 1.61-5.65, P = 0.0005), plasma C-reactive protein (CRP) level (95% CI: 0.87-0.99, P = 0.016) and HCY < 17.55 μmol/L (95% CI: 2.43-8.72, P < 0.0001) were found to be independent predictors for SR.

Conclusion: In patients with STEMI, HCY < 17.55 μmol/L, preinfarct angina and plasma CRP level were independent predictors of SR.

Keywords: Homocysteine; Pre-interventional IRA patency; Predictor; ST-segment elevation myocardial infarction; Spontaneous reperfusion.

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Conflict of interest statement

Ethics approval and consent to participate

The study was conducted according to the principles of the Declaration of Helsinki and approved by the China-Japan Friendship Hospital on Human Health Ethic Committee. Participation to the study was voluntary and written informed consent was obtained from each participant. We have received permission from the local hospital management to access patient medical records.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
ROC curve for HCY levels in patients with SR in the baseline angiography. The mean area under the ROC curve was 0.70.
See this image and copyright information in PMC

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References

    1. Zeymer U, Huber K, Fu Y, et al. Impact of TIMI 3 patency before primary percutaneous coronary intervention for ST-elevation myocardial infarction on clinical outcome: results from the ASSENT-4 PCI study. Eur Heart J Acute Cardiovasc Care. 2012;1(2):136–142. doi: 10.1177/2048872612447069. - DOI - PMC - PubMed
    1. Lekston A, Hudzik B, Szkodzinski J, et al. Spontaneous reperfusion before intervention improves immediate but not long-term prognosis in diabetic patients with ST-segment elevation myocardial infarction and multivessel coronary artery disease. Cardiol J. 2013;20(4):378–384. doi: 10.5603/CJ.2013.0096. - DOI - PubMed
    1. Christian TF, Milavetz JJ, Miller TD, Clements IP, Holmes DR, Gibbons RJ. Prevalence of spontaneous reperfusion and associated myocardial salvage in patients with acute myocardial infarction. Am Heart J. 1998;135(3):421–427. doi: 10.1016/S0002-8703(98)70317-5. - DOI - PubMed
    1. Bainey KR, Fu Y, Granger CB, et al. Investigators AA. Benefit of angiographic spontaneous reperfusion in STEMI: does it extend to diabetic patients? Heart. 2009;95(16):1331–1336. doi: 10.1136/hrt.2008.160390. - DOI - PubMed
    1. Stone GW, Cox D, Garcia E, et al. Normal flow (TIMI-3) before mechanical reperfusion therapy is an independent determinant of survival in acute myocardial infarction: analysis from the primary angioplasty in myocardial infarction trials. Circulation. 2001;104(6):636–641. doi: 10.1161/hc3101.093701. - DOI - PubMed

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