Predictive value of homocysteine for major adverse cardiovascular events risk in female community population

Objective To investigate the predict value of homocysteine (HCY) for major adverse cardiovascular events risk among the community-dwelling female population. Methods This was a community-based prospective observational study.From September 2007 to January 2009,a total of 870 female subjects with average age of 58.81 years were recruited from a community-based population in Beijing.Participants were divided into group A (<12.3 μmol/L,n=212),group B (12.3-15.2μmol/L,n=221),group C (15.3-18.3μmol/L,n=218) and group D (≥18.4μmol/L,n=219) according to the baseline HCY level.Their baseline clinical data were recorded,indicators including major adverse cardiovascular events (MACE),HCY and cfPWV were detected.Patients were followed-up for average of 4.8 years,and MACE and all-cause mortality were also recorded,and the predictive role of HCY for major cardiovascular events was evaluated. Results Compared with group A,B and C,the age in group D was significantly higher,the levels of SBP,uric acid,cfPWV were higher,while levels of HDL-C and eGFR were significantly lower (all P<0.05).During a average 4.8-year follow-up period,23 participants (2.6%) died,42 participants (4.8%) suffered MACE.The incidences of MACE and all-cause mortality were significantly higher in group D compared to group A (7.3% vs 1.4%,5.5% vs 0.5%,P<0.01,respectively).Cox regression analysis showed that the risks of MACE and all-cause mortality were significantly higher in group D than that in group A after adjusting for traditional risk factors (P<0.05).The area under the ROC curve for HCY in predicting MACE and all-cause mortality were 0.615 (95% CI:0.533-0.698) and 0.695 (95% CI:0.583-0.806),respectively. Conclusion The plasma HCY level is a potential and independent predictive factor for major adverse cardiovascular events risk in female community population.