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Predictive Significance of High-Sensitivity C-Reactive Protein Combined with Homocysteine for Coronary Heart Disease
Changhe Liu1, Na Hua2, Yanli Zhang3
1Department of Cardiology, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China.
Insights
Biomarkers like high-sensitivity C-reactive protein (hs-CRP) and homocysteine (Hcy) can help predict coronary heart disease (CHD) in patients with anxiety disorders. Combined detection of hs-CRP and Hcy shows significant predictive value for CHD in this population.
Area of Science:
- Cardiology
- Psychiatry
- Biomarker Research
Background:
- Limited research exists on biomarkers for predicting coronary heart disease (CHD) in patients with anxiety disorders.
- Anxiety disorders are increasingly recognized as a comorbidity impacting cardiovascular health.
- Understanding predictive biomarkers is crucial for early intervention and management.
Purpose of the Study:
- To identify risk factors for CHD in patients with anxiety disorders.
- To evaluate the predictive value of common peripheral blood indicators, specifically high-sensitivity C-reactive protein (hs-CRP) and homocysteine (Hcy).
- To explore the combined diagnostic efficacy of hs-CRP and Hcy for CHD in anxious patients.
Main Methods:
- 153 hospitalized patients with chest pain and anxiety (Hamilton Anxiety Scale score > 14) were recruited.
- Patients were categorized into an anxiety disorder with CHD group (n=64) and a simple anxiety disorder group (n=89) based on coronary angiography.
- Peripheral blood levels of IL-6, hs-CRP, Hcy, and other markers were compared; logistic regression and ROC curve analyses were performed.
Main Results:
- Interleukin-6 (IL-6), hs-CRP, and Hcy levels were significantly elevated in the CHD with anxiety group compared to the simple anxiety group.
- IL-6, hs-CRP, and Hcy were identified as independent risk factors for CHD in patients with anxiety disorders.
- Combined detection of hs-CRP and Hcy demonstrated superior predictive value for CHD in anxious patients compared to single markers, with a significantly larger area under the curve (AUC).
Conclusions:
- Interleukin-6 (IL-6), hs-CRP, and Hcy are associated with the presence of CHD in patients experiencing anxiety disorders.
- The combined assessment of serum hs-CRP and Hcy levels offers high clinical predictive value for identifying CHD in patients with anxiety disorders.
- This finding supports the utility of these biomarkers in risk stratification for comorbid CHD and anxiety.
Background:
Currently, there are few studies on biomarkers for predicting coronary heart disease (CHD) with anxiety disorders.
Objective:
To explore risk factors and investigate the predictive value of common clinical peripheral blood indicators, such as high-sensitivity C-reactive protein (hs-CRP) and homocysteine (Hcy) for CHD patients with anxiety disorders.
Methods:
One hundred fifty-three hospitalized patients with chest pain as the main symptom and a Hamilton Anxiety Scale score > 14 were recruited from October 2020 to September 2021 in the hospital. Then, they were divided into an anxiety disorder with CHD group (observation group, n = 64) and a simple anxiety disorder group (control group, n = 89), according to coronary angiography (CAG) findings. Patients' demographic and clinical messages were collected and compared. Diabetes mellitus and hypertension, body mass index (BMI), and peripheral blood interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), homocysteine (Hcy), fibrinogen, D-dimer, cortisol, and norepinephrine expression levels were compared. Binary logistic regression analysis screened independent risk factors of CHD patients with anxiety disorders. The effectiveness of independent risk factors in predicting CHD with anxiety disorders was analyzed using receiver operating characteristic (ROC) curves.
Results:
IL-6, hs-CRP, and Hcy levels of anxiety disorder in the CHD group were significantly higher than those in the simple anxiety disorder group. Binary multiple logistic regression analysis indicated that IL-6, hs-CRP, and Hcy were independent risk factors for CHD in patients with anxiety disorders. hs-CRP and Hcy levels were positively correlated with the Gensini score. ROC curve analysis indicated that the detection of hs-CRP or Hcy alone or the combined detection of the 2 had clinical predictive value for CHD in patients with anxiety disorders, and the area under the curve (AUC) of the combined detection of the 2 was significantly larger than that of any single factor alone (vs. hs-CRP, P = 0.045; vs. Hcy, P = 0.045).
Conclusion:
IL-6, hs-CRP, and Hcy are related to CHD with anxiety disorders. Serum levels of the combined detection of hs-CRP and Hcy have a high clinical predictive value for CHD in patients with anxiety disorders.
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