Vol 60, No 3 (2004)
Other
Published online: 2005-12-12
Homocysteine and progression of coronary artery disease
DOI: 10.33963/v.kp.81934
Kardiol Pol 2004;60(3):202-205.
Abstract
Background: Hyperhomocysteinemia is one of the newly recognised risk factors of coronary artery disease (CAD). The role of hyperhomocysteinemia in the development of atherosclerosis has been controversial.
Aim: To assess homocysteine (Hcy) plasma concentration in patients with CAD and to correlate Hcy level with some cardiovascular risk factors.
Methods: The study group consisted of 150 males aged <55 years (mean age 49.5±5.7 years) with stable CAD. Lipid and carbohydrate profiles as well as Hcy, folic acid and vitamin B12 serum concentration were assessed, and correlated with such cardiovascular risk factors as cigarette smoking, hypertension, obesity and a history of myocardial infarction.
Results: Mean Hcy plasma concentration was 11.81±3.75 µmol/L. In patients with Hcy >11.21 µmol/L (median value) a lower level of folic acid and vitamin B12 as well as reduced ejection fraction and glomerular filtration rate were found when compared to patients with Hcy level <11.21 µmol/L. In addition, creatinine concentration, mean patient's age, proportion of patients who smoked cigarettes and the number of affected coronary arteries were significantly higher in patients with an increased level of Hcy. The Hcy plasma concentration positively correlated with the progression of hypertension, creatinine level and the number of coronary vessels with stenosis. A significant negative correlation between Hcy and folic acid as well as vitamin B12 concentrations was documented. In patients with a three-vessel CAD, Hcy concentration was 12.46±3.85 µmol/L and was significantly higher (p<0.03) compared with patients with a less advanced CAD. In the group of patients with diabetes the mean Hcy concentration increased with the number of affected coronary vessels (p<0.02) and reached the highest values in patients with a three-vessel CAD (15.38±7.28 µmol/L).
Conclusions: There is a significant relationship between homocysteine plasma concentration and the incidence as well as progression of CAD. This association is particularly evident in patients with diabetes.
Aim: To assess homocysteine (Hcy) plasma concentration in patients with CAD and to correlate Hcy level with some cardiovascular risk factors.
Methods: The study group consisted of 150 males aged <55 years (mean age 49.5±5.7 years) with stable CAD. Lipid and carbohydrate profiles as well as Hcy, folic acid and vitamin B12 serum concentration were assessed, and correlated with such cardiovascular risk factors as cigarette smoking, hypertension, obesity and a history of myocardial infarction.
Results: Mean Hcy plasma concentration was 11.81±3.75 µmol/L. In patients with Hcy >11.21 µmol/L (median value) a lower level of folic acid and vitamin B12 as well as reduced ejection fraction and glomerular filtration rate were found when compared to patients with Hcy level <11.21 µmol/L. In addition, creatinine concentration, mean patient's age, proportion of patients who smoked cigarettes and the number of affected coronary arteries were significantly higher in patients with an increased level of Hcy. The Hcy plasma concentration positively correlated with the progression of hypertension, creatinine level and the number of coronary vessels with stenosis. A significant negative correlation between Hcy and folic acid as well as vitamin B12 concentrations was documented. In patients with a three-vessel CAD, Hcy concentration was 12.46±3.85 µmol/L and was significantly higher (p<0.03) compared with patients with a less advanced CAD. In the group of patients with diabetes the mean Hcy concentration increased with the number of affected coronary vessels (p<0.02) and reached the highest values in patients with a three-vessel CAD (15.38±7.28 µmol/L).
Conclusions: There is a significant relationship between homocysteine plasma concentration and the incidence as well as progression of CAD. This association is particularly evident in patients with diabetes.
Keywords: homocysteine - diabetes - coronary artery disease - atherosclerosis
