Hyperhomocysteinemia Predicts the Severity of Coronary Artery Disease as Determined by the SYNTAX Score in Patients with Acute Coronary Syndrome

Background: Hyperhomocysteinemia is a known risk factor for acute coronary syndrome (ACS) and is related with the severity of coronary artery disease (CAD). Previous studies have used less quantifiable scoring systems for assessing the severity of CAD. Therefore, we aimed to assess the relationship between homocysteine levels and SYNTAX score (SXscore), which is currently more widely used to grade the severity of CAD. Methods: A total of 503 patients with adiagnosis of ACS were examined angiographically with SXscore. The patients were divided into three groups according to SXscore; Group 1 a low SXscore <= 22), Group 2 a moderate SXscore (23-32), and Group 3 a high SXscore (>= 33). Results: Plasma homocysteine levels were 16.3 +/- 6.2 nmol/mL in Group 1, 18.1 +/- 9.6 nmol/mL in Group 2, and 19.9 +/- 9.5 nmol/mL in Group 3. Homocysteine levels were significantly higher in Group 2, and Group 3 compared to Group 1 (p = 0.023 and 0.007, respectively). In the correlation analysis, homocysteine levels were correlated with SXscore (r: 0.166, p < 0.01). Conclusions: Serum homocysteine levels on admission were associated with an increased severity of CAD in the patients with ACS.