Serum Homocysteine and High-Sensitivity C-Reactive Protein as Predictors of Severity in Acute Coronary Syndrome: A Prospective Observational Study

Nityanand Rao Patil; Patil Archana; Jai Bharat Bhalke

doi:10.37022/wjcmpr.v8i3.451

Authors

Nityanand Rao Patil Associate Professor, Department of General Medicine, Jagannath Gupta Institute of Medical Sciences & Hospital (JIMSH), North Kolkata.
Patil Archana Associate Professor, Department of Pathology, TRR Institute of Medical Sciences (TRR IMS), Inole, Hyderabad.
Jai Bharat Bhalke Associate Professor, Department of General Medicine, Jagannath Gupta Institute of Medical Sciences & Hospital (JIMSH), North Kolkata.

Abstract

Background: Homocysteine and high-sensitivity C-reactive protein (hs-CRP) may reflect complementary pathways involved in coronary atherosclerosis. This study evaluated their relationship with angiographic severity in acute coronary syndrome (ACS).

Methods: In this prospective observational study, 180 patients with ACS underwent serum homocysteine and hs-CRP measurement and coronary angiography. Disease burden was assessed using the Gensini score, with high severity defined as ≥40.

Results: Median homocysteine was 14.45 µmol/L and hs-CRP 6.35 mg/L. Both biomarkers correlated with Gensini score (homocysteine ρ=0.339; hs-CRP ρ=0.391; both p<0.001) and were higher in patients with severe angiographic disease. After adjustment, hs-CRP remained independently associated with high Gensini severity (OR 2.52 per doubling; p<0.001), while homocysteine showed a borderline association (OR 1.38 per 5 µmol/L; p=0.050). Addition of both biomarkers increased AUC from 0.695 to 0.765.

Conclusion: hs-CRP was a stronger predictor of angiographic severity, while homocysteine provided complementary prognostic information.

Keywords:

Acute coronary syndrome, Homocysteine, hs-CRP, Gensini score, Coronary artery disease

DOI

https://doi.org/10.37022/wjcmpr.v8i3.451

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