Hyperhomocysteinemia as a Risk Factor for Coronary Artery Disease / 대한진단검사의학회지

ABSTRACT

BACKGROUND: Hyperhomocysteinemia is considered as a risk factor for coronary artery disease (CAD). In this study, we investigated the relationship between plasma homocysteine concentration and coronary artery disease. METHODS: We measured plasma homocysteine concentration by fluorescent polarization immunoas-say (IMx, Abbott) in 58 healthy controls (39-72 years) and in 37 patients (42-84 years) who were diagnosed with stable angina (11), unstable angina (14), acute myocardial infarction (8), old myocardial infarction (1) and silent myocardial ischemia (3). RESULTS: The risk of CAD was independently associated with old age, decreased HDL cholesterol and hyperhomocysteinemia (P >or=12.8 nmol/L) and adjusted odds ratios were 2.8, 3.4, and 6.0, respec-tively. The risk for CAD in the upper two homocysteine quartiles (P >or=10.8 nmol/L and 8.1- 10.7 nmol/L) was 11.1 (95% CI, 2.5- 49.4) times and 6.3 (95% CI, 1.4- 27.7) times higher than in the lowest quar-tile (<6.9 nmol/L) (P=0.002 and 0.014, respectively). The mean plasma homocysteine values (M +/- SD) were higher in CAD patients (11.8 +/- 7.4 nmol/L) than in the control group (8.0 +/- 2.4 mol/L) (P=0.0006). In the control group, the mean plasma homocysteine concentration in men was signifi-cantly igher than in women (9.1 vs. 7.2 mol/L, P=0.002). Age and logarithmically transformed plasma homocysteine levels exhibited significant positive correlation in controls (r=0.43, P=0.001), ut no significant correlation in CAD patients (r=-0.024, P=0.9). Plasma homocysteine levels were significantly higher in the elderly, male subjects and smokers in the univariate analysis. CONCLUSIONS: Hyperhomocysteinemia is one of the independent risk factors for CAD.