The predictive value of serum homocysteine for adverse events after percutaneous coronary intervention in elderly patients with acute coronary syndrome

[Objective] To investigate the predictive value of serum homocysteine (Hcy) for the occurrence of major adverse cardiovascular events (MACE) within 30 days after percutaneous coronary intervention (PCI) in elderly patients with acute coronary syndrome (ACS). [Methods] A prospective study was conducted in 153 elderly patients with acute coronary syndrome admitted to Changchun Central Hospital from October 2023 to March 2024. The patients were followed up for 30 days on the first day after PCI. The patients were divided into an occurrence group and a non-occurrence group according to the occurrence of MACE. Multivariate logistic regression model was used to analyze the influencing factors of MACE, and ROC curve was used to analyze the predictive value of serum Hcy for the occurrence of MACE after PCI. [Results] Twenty-seven patients developed MACE, and the levels of Hcy, low density lipoprotein cholesterol(LDL-C), and uric acid（UA） in the group that developed MACE were higher than those in the group that did not develop MACE(P<0.05); multivariate logistic regression analysis showed that Hcy, UA, and LDL-C were all independent risk factors for MACE after PCI in elderly patients with acute coronary syndrome (P<0.05); ROC curves showed that Hcy had a certain predictive mechanism for MACE after PCI in elderly patients with acute coronary syndrome, with an area under the curve of 0.687 (95% CI: 0.558-0.815, P= 0.002). [Conclusion] Serum Hcy is a risk factor for MACE in elderly patients with acute coronary syndrome in the short term after PCI, and it has some predictive value for the occurrence of MACE.