LAUSR

Introduction: Coronary heart disease is a leading cause of death in developing countries. The world health organization (WHO) estimates that by 2020 the incidence of coronary heart disease will increase from 7.1 million to 11.1 million. Atherosclerosis is the main cause of coronary heart disease. Several studies reported risk factors for atherosclerosis include smoking, hypertension, diabetes and homocysteine levels. In addition to risk factors such as atherosclerosis, platelets have an important role in developing coronary heart disease in the form of acute coronary syndromes. Increased platelet activity as measured by mean platelet volume (MPV) also increases the incidence of acute coronary syndrome.This study aims to determine the relationship between homocysteine levels and mean platelet volume to the severity of coronary stenosis in patients with acute coronary syndrome. Method: This is an observational study with a cross-sectional approach and was carried out in June—August 2018. The number of samples in this study were 47 patients. All study subjects who met the inclusion criteria were taken history and physical examination including age, sex, weight, height, blood pressure, history of dyslipidemia, history of diabetes, history of hypertension, and routine laboratory examinations. After that, the subject who met the inclusion criteria had blood samples examination for homocysteine levels and MPV, and then underwent coronary angiography examination and performed an assessment of the severity of coronary stenosis through Jenkins modified gensini score. Finally, statistical analysis was performed to find correlation between plasma homocysteine and mean platelet volume with Jenkins modified gensini score. Result: From a total of 47 subjects, 30 patients (64%) were male with an average age of nearly 60 ± 10 years. The value of the lipid profile, cardiac parameters are generally within normal limits. There is an increase in leukocytes above the upper limit value with an average value of 11,600 /μL. The average value of whole serum homocysteine in the patient is at 12 μmol/L with a deviation levels of about 3.1 μmol/L, while the MPV value is at 9.8 ± 0.7 fL. In this study, we found that an increase in homocysteine levels of 1 μmol/L causing the possibility of individuals experiencing coronary artery stenosis with a gensini score of > 13 by 2-fold. The association between MPV and the severity of coronary artery stenosis showed patients with MPV 9.6-10.5 fL experienced a reduction in severe lesion odds of 1.0000.021 compared to ≤ 9.5fL. There is a positive relationship between homocysteine levels and the severity of coronary artery stenosis, but the relationship between MPV and severity of coronary artery stenosis has not been fully answered with available data.