摘要
脉管的光滑的肌肉房间的迁居和增长上的 homocysteine (Hcy ) 的 BackgroundThe 影响很好被建立了。然而， Hcy 的影响在非犯人的前进上铺平冠的损害(NCCL ) 是争论的。这研究试图评估 Hcy 的血浆水平是否与在在有急性冠的症候群(交流) 的老病人的经皮的冠的 stent 培植以后的 NCCL 的前进有关 223 个老病人的 .MethodsA 总数(≥；65 岁) 与经历 stent 培植和后续的交流，冠的 angiography 被注册。为 Hcy 由血样品评估组成的实验室决心在基线前被执行冠的干预。病人根据血 Hcy tertiles 被分类进二个组(≥；15 mmol/L 或 <；15 mmol/L ) 。病人们被跟随在上面为 12.2 个月。NCCL 前进被三维的量的冠的 angiography.ResultsA 估计 NCCL 前进的显著地更高的比率与下面的集中与这个组相比在 15 mmol/L 上面与基线 Hcy 集中在这个组被观察 15 mmol/L (41/127， 32.3% 对 14/96， 14.6% ， P = 0.002 ) 。穆尔蒂瓦里伊特·考克斯回归分析证明 Hcy 和糖尿病 mellitus 是为 NCCL 前进的独立风险因素。为 Hcy 水平的 NCCL 前进的粗略的危险比率(HR ) 是 1.056 (95% CI：1.01-1.104， P = 0.015 ) 。为 Hcy 水平的 NCCL 前进的调整 HR 是 1.024 (95% CI：1.007-1.042， P = 0.007 ) 。为糖尿病 mellitus 的 NCCL 前进的调整 HR 是 1.992 (95% CI：1.15-3.44， P = 0.013 ).ConclusionsHcy 是为在 12 月在有交流的老病人的后续以后的 NCCL 前进的一个独立风险因素经历了经皮的冠的 stenting。
Background The influence of homocysteine （Hcy） on the migration and proliferation of vascular smooth muscle cells has been well established. However, the impact of Hcy levels on the progression of non-culprit coronary lesions （NCCLs） is controversial. This study aims to evaluate whether the plasma level of Hcy is related to the progression of NCCLs after percutaneous coronary stent implantation in elderly patients with acute coronary syndrome （ACS）. Methods A total of 223 elderly patients （〉 65 years old） with ACS undergoing stent im- plantation and follow-up coronary angiography were enrolled. Laboratory determination comprised of blood sample evaluation for Hcy was carried out before baseline coronary intervention. The patients were classified into two groups according to the blood Hcy tertiles （〉 15 mmol/L or 〈 15 mmol/L）. Patients were followed up for 12.2 months. NCCL progression was assessed by three-dimensional quantitative coronary angiography. Results A significantly higher ratio of NCCL progression was observed in the group with baseline Hcy concentrations above 15 mmol/L compared to the group with concentrations below 15 mmol/L （41/127, 32.3% vs. 14/96, 14.6%, P = 0.002）. Multivariate Cox regression analysis showed that Hcy and diabetes mellitus were independent risk factors for NCCL progression. The crude haz- ard ratio （HR） of NCCL progression for Hcy level was 1.056 （95% CI： 1.01-1.104, P = 0.015）. The adjusted HR of NCCL progression for Hcy level was 1.024 （95% CI： 1.007-1.042, P = 0.007）. The adjusted HR of NCCL progression for diabetes mellitus was 1.992 （95% CI： 1.15-3.44, P = 0.013）. Conclusions Hcy is an independent risk factor for NCCL progression after 12 months of follow-up in elderly patients with ACS who has undergone percutaneous coronary stenting.
