Serum level of homocysteine and the development of collateral circulation in patients with severe coronary artery stenosis

Objective To investigate the relationship between serum level of homocysteine and the development of collaterals in patients with severe coronary artery stenosis(SCAS). Methods Eighty patients with at least one vessel stenosis over 90% among the 3 main vessels of coronary artery were consecutively enrolled into the study according to angiographic estimation. The development of collaterals was classified by Rentrop’s method. Results The serum levels of homocysteine among the single-vessel, bi-vessel and tri-vessel coronary artery disease groups had no significant difference; there was no linear correlation between the serum level of homocysteine and Gensini’s score. The level of homocysteine in the poorly developed collaterals was significantly higher than that in the well-developed collaterals in the SCAS patients (P0.001). Multiple stepwise logistic analysis revealed that homocysteine negatively correlated with the development of collaterals (P0.001,odds ratio=0.353; 95% confidence interval=0.201~0.620),whereas it positively correlated with the number of stenosis vessels. Conclusion The serum level of homocysteine is independently and negatively associated with the development of collateral circulation in severe SCAs patients.