Value and level of plasma homocysteine in patients with angina pectoris undergoing coronary angiographic study

Correlation of serum homocysteine levels with the severity of coronary artery disease

Coronary artery disease (CAD) has become the most common cause of mortality in the entire world. Homocysteine is implicated as an early atherosclerotic promoter. We studied the relationship between levels of serum homocysteine with severity of coronary artery disease. Total of 70 subjects who scheduled for coronary angiogram consented to participate in this study. In all the patients Gensini scoring system was used to assess the severity of CAD. Venous samples were taken from the patients in fasting state before angiography. Homocysteine levels in patients were measured by enzyme linked immunosorbant method and were compared with respective Genseni scores of participants. Fasting serum homocysteine levels in CAD patients were significantly higher than patients without coronary artery disease (p < 0.001). Also Homocyseine levels correlated significantly with increasing severity of CAD (p < 0.001). Serum homocysteine levels correlated well with the severity of CAD.

Hyperhomocysteinemia is an independent risk factor in young patients with coronary artery disease in southern China

BACKGROUND

Elevated plasma homocysteine (Hcy) is considered to be a risk factor of coronary artery disease (CAD), although this is still controversially discussed. This study investigated the role of Hcy in young patients with CAD in southern China.

METHODS

A total of 146 consecutive patients (aged ≤ 55 years) with angiographically proven CAD were enrolled in the study and 138 age-matched non-CAD individuals were included as the control group. Hcy levels were measured by enzymatic assay. Hyperhomocysteinemia (HHcy) was defined as Hcy ≥ 15 µmol/l. A 10-year CAD risk was calculated using the Framingham risk score (FRS) modified according to the National Cholesterol Education Program Adult Treatment Panel III.

RESULTS

There were significant differences between the CAD and control groups with regard to male sex (P < 0.01), smoking history (P < 0.05), and triglyceride levels (TG, P < 0.05), but no remarkable difference in other conventional risk factors (all P > 0.05). Hcy and high-sensitivity C-reactive protein (hs-CRP) levels were significantly higher in the CAD group than those in the control group (both P < 0.05). The FRS and estimated 10-year absolute CAD event risk were low in both groups and did not show a statistical difference. Multivariate logistic regression showed that male sex (odds ratio, OR, 3.68; 95 % confidence interval, 95 % CI, 1.54-10.01), smoking (OR, 2.54; 95 % CI, 1.15-5.36), TG (OR, 1.30; 95  % CI, 1.08-3.06), hs-CRP (OR, 3.74; 95 % CI, 1.72-12.21), and HHcy (OR, 2.03; 95 % CI, 1.26-5.83) were independently correlated with CAD in young patients.

CONCLUSION

HHcy is an important independent risk factor for CAD in young patients in southern China after adjusting for other risk factors.