The Relation between Homocysteine Levels in Patients with Acute Coronary Syndrome and Grace Score

Objectives: This study investigated the correlation between homocysteine levels in patients with Acute Coronary Syndrome and GRACE Score.
Methods: This study included 191 cases -140 Non-ST MI cases and 51 MI with ST-elevation cases in Þiþli Etfal Training and Research Hospital Coronary Intensive Care Unit between December 2008 and March 2010. Homocysteine was measured by immulite 2000 device, using kemiluminesans method and competitive immunoassay principle and a kit by DPC was used during the measurement. The reference range given by the producing company was between 5-15 Mmol/L for male and female adults. The patients were classified into three risk groups as low, medium and high on the basis of the criteria identified in GRACE risk score: age, heart rate, systolic blood pressure, serum creatine levels, Killip classification, cardiac arrest on admission, increased cardiac enzymes and ST segment depression. The relation between homocysteine levels in patients with Acute Coronary Syndrome and GRACE risk score was evaluated.
Results: In the Non-ST MI group, a statistically-moderate positive correlation was seen between homocysteine and GRACE risk score during the study (p<0.05). However, in the MI with ST-elevation group, no correlation was found between homocysteine and GRACE risk score (p>0.05). Overall, despite the low figures, a meaningful positive relation was observed between homocysteine and GRACE risk score in all cases.
Conclusion: Homocysteine is independent of other classic risk factors for cardiovascular diseases. Therefore, we believe that routine plasma homocysteine levels should be checked when evaluating risk factors for Atherosclerotic Coronary Artery disease.

Akut Koroner Sendromlu Hastalarda Homosistein Düzeyinin Grace Skorlamasi Ýle Ýliþkisi

Amaç: Bu çalýþmada akut koroner sendromlu hastalarda homosistein düzeyinin GRACE skorlamasý ile iliþkisini araþtýrdýk.
Materyal-Metod: Aralýk 2008-Mart 2010 tarihleri arasýnda hastanemiz Koroner Yoðun Bakým Ünitesi’ nde yatan 140 olgu NonST MI ve 51 olgu ST elevasyonlu MI olmak üzere toplam 191 hasta çalýþma kapsamýna alýndý. Homosisteinin referans aralýðý, eriþkin erkek ve kadýnlarda 5-15 Mmol/ L’ dir. GRACE risk skorunda daha önce tanýmlandýðý üzere yaþ, kalp hýzý, sistolik kan basýncý, serum kreatinin düzeyi, Killip sýnýfý, baþvuruda kardiyak arrest, artmýþ kardiyak enzimler ve ST segment depresyonuna göre hastalar düþük, orta, yüksek olmak üzere üç risk grubuna ayrýldý. Akut Koroner Sendromlu hastalarda homosistein düzeyinin GRACE risk skoru ile iliþkisi deðerlendirildi.
Bulgular: Çalýþmamýzda NonST MI grupta;homosistein ile GRACE risk skoru arasýnda zayýf düzeyde olmakla beraber istatistiksel olarak pozitif yönde,anlamlý bir iliþki görülmektedir (p< 0,05). ST elevasyonlu MI grubunda ise homosistein ile GRACE risk skoru arasýnda istatistiksel olarak anlamlý iliþki görülmemektedir (p> 0,05). Tüm olgularda bakýldýðýnda; homosistein ile GRACE risk skoru arasýnda zayýf düzeyde olmakla beraber istatistiksel olarak pozitif yönde, anlamlý bir iliþki görülmektedir (p< 0,05).
Sonuç: Homosistein kardiyovasküler hastalýklar için tanýmlanan klasik risk faktörlerinden baðýmsýz bir risk faktörüdür. Bu yüzden aterosklerotik koroner arter hastalýðý risk faktör deðerlendirilmesine rutin plazma homosistein düzeylerine bakýlmasý gerektiðine inanmaktayýz. (SETB-2018-09-127)