[Occurrence and prognosis of coronary slow flow in emergency percutaneous coronary intervention: correlations with homocysteine].

OBJECTIVE: To investigate the correlation of the occurrence and prognosis of coronary slow flow phenomenon (CSF) with blood homocysteine (Hcy) levels in patients receiving emergency percutaneous coronary intervention therapy (PCI). METHODS: From January, 2010 to December, 2011, 138 patients with ST-elevation myocardial infarction received emergency angioplasty, among whom 46 patients developed CSF and 92 did not (control group). Blood Hcy levels were determined in these patients. The patients with CSF were classified into two groups with mild and moderate Hcy elevations (32 and 14 cases, respectively), and the left ventricular ejection fraction (LVEF) during hospitalization and at 3 months of follow-up as well as major adverse cardiac events (MACE) were compared between the two groups and analyzed for their association with Hcy level. RESULTS: The patients with CSF showed significantly higher blood Hcy levels than the control patients (P=0.001). At 3 months of follow-up, the patients with CSF and moderate Hcy elevation had significantly lower LVEF (P=0.031) and higher incidence of MACE (P=0.019) than those with mild Hcy elevation. Hcy levels were negatively correlated with LVEF (r=-0.310, P=0.036) and positively with MACE (r=0.342, P=0.02). CONCLUSION: A high blood Hcy level is closely correlated with the occurrence of CSF in emergency PCI, affects the recovery of LVEF and increases the incidence of MACE.