Advertisement

Correlation of homocysteine levels with the extent of coronary atherosclerosis in patients with low cardiovascular risk profiles

      Abstract

      Elevation of homocysteine is now known as an independent risk factor for vascular diseases. However, influences of homocysteine to the extent of coronary atherosclerosis in patients with different coronary risk profiles have not been studied. In this study, we used angiographic “diffuse score” and “clinical vessel score” to evaluate the extent of coronary atherosclerosis, and examined the correlation between levels of serum total homocysteine and angiographic scores among patients with high- and low-risk profiles. Seventy consecutive patients (58 men and 12 women, mean age 50 years) undergoing selective coronary angiography for the first time were recruited for this study. Patients were divided into high-risk (risk factor ≥3, n = 35) and low-risk (risk factor <3, n = 35) groups. Linear regression analysis revealed that levels of serum homocysteine were only significantly correlated with diffuse (r = 0.217, p = 0.007) and clinical vessel (r = 0.078, p = 0.037) scores in low-risk patients. These correlations could not be observed in diffuse (r = 0.070, p = 0.319) and clinical vessel (r = −0.001, p = 0.970) scores in the high-risk group. In conclusion, levels of homocysteine correlated with the extent of coronary atherosclerosis only among patients with low cardiovascular risk profiles.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Stampfer M.J
        • Malinow R
        • Willett W.C
        • Newcomer L.M
        • Upson B
        • Ullmann D
        • Tishler P.V
        • Hennekens C.H
        A prospective study of plasma homocyst(e)ine and risk of myocardial infarction in US physicians.
        JAMA. 1992; 268: 877-881
        • Robinson K
        • Mayer E.L
        • Miller D.P
        • Green R
        • van Lente F
        • Gupta A
        • Kottke-Marchant K
        • Savon S.R
        • Selhub J
        • Nissen S.E
        • et al.
        Hyperhomocysteinemia and low pyridoxal phosphate.
        Circulation. 1995; 92: 2825-2830
        • Taylor L.M
        • DeFrang R.D
        • Harris E.J
        • Porter J.M
        The association of elevated plasma homocyst(e)ine with progression of symptomatic peripheral arterial disease.
        J Vasc Surg. 1991; 13: 128-136
        • Arnesen E
        • Refsum H
        • Bonaa K.H
        • Ueland P.M
        • Forde O.H
        • Nordrehaug J.E
        Serum total homocysteine and coronary heart disease.
        Int J Epidemiol. 1995; 24: 704-709
        • Clarke R
        • Daly L
        • Robinson K
        • Naughten E
        • Cahalane S
        • Fowler B
        • Graham I
        Hyperhomocysteinemia.
        N Engl J Med. 1991; 324: 1149-1155
        • Glueck C.J
        • Shaw P
        • Lang J.E
        • Tracy T
        • Sieve-Smith L
        • Wang Y
        Evidence that homocysteine is an independent risk factor for atherosclerosis in hyperlipidemic patients.
        Am J Cardiol. 1995; 75: 132-136
        • Welch G.N
        • Loscalzo J
        Homocysteine and atherothrombosis.
        N Engl J Med. 1998; 338: 1042-1050
        • Montalescot G
        • Ankri A
        • Chadefaux-Vekemans B
        • Blacher J
        • Philippe F
        • Drobinski G
        • Benzidia R
        • Kamoun P
        • Thomas D
        Plasma homocysteine and the extent of atherosclerosis in patients with coronary artery disease.
        Int J Cardiol. 1997; 60: 295-300
        • Konecky N
        • Malinow R
        • Tunick P.A
        • Freedberg R.S
        • Rosenzweig B.P
        • Katz E.S
        • Hess D.L
        • Upson B
        • Leung B
        • Perez J
        • Kronzon I
        Correlation between plasma homocyst(e)ine and aortic atherosclerosis.
        Am Heart J. 1997; 133: 534-540
        • Brattstrom L
        • Israelsson B
        • Norrving B
        • Bergqvist D
        • Thorne J
        • Hultberg B
        • Hamfelt A
        Impaired homocysteine metabolism in early-onset cerebral and peripheral occlusive arterial disease.
        Atherosclerosis. 1990; 81: 51-60
        • Wu L.L
        • Wu J
        • Hunt S.C
        • James B.C
        • Vincent G.M
        • Williams R.R
        • Hopkins P.N
        Plasma homocyst(e)ine as a risk factor for early familial coronary artery disease.
        Clin Chem. 1994; 40: 552-561
        • Schwartz S.M
        • Siscovick D.S
        • Malinow R
        • Rosendaal F.R
        • Beverly K
        • Hess D.L
        • Psaty B.M
        • Longstreth W.T
        • Koepsell T.D
        • Raghunathan T.E
        • Reitsma P.H
        Myocardial infarction in young women in relation to plasma total homocysteine, folate, and a common variant in the methylenetetrahydrofolate reductase gene.
        Circulation. 1997; 96: 412-417
        • Ubbink J.B
        • Vermaak W.J.H
        • Bissbort S
        Rapid high-performance liquid chromatographic assay for total homocysteine levels in human serum.
        J Chromatogr. 1991; 565: 441-446
        • Egerton W
        • Siberberg J
        • Crooks R
        • Ray C
        • Xie L
        • Dudman N
        Serial measures of plasma homocysteine after acute myocardial infarction.
        Am J Cardiol. 1996; 77: 759-761
        • Negri M
        • Sheiban I
        • Arigliano P.L
        • Tonni S
        • Montresor G
        • Carlini S
        • Manzato F
        Interrelation between angiographic severity of coronary artery disease and plasma levels of insulin, C-peptide and plasminogen activator inhibitor-1.
        Am J Cardiol. 1993; 72: 397-401
        • Birnie D.H
        • Holme E.R
        • McKay I.C
        • Hood S
        • McColl K.E.L
        • Hillis W.S
        Association between antibodies to heat shock protein 65 and coronary atherosclerosis.
        Eur Heart J. 1998; 19: 387-394
        • Sullivan D.R
        • Marwick T.H
        • Freedman S.B
        A new method of scoring coronary angiograms to reflect extent of coronary atherosclerosis and improve correlation with major risk factors.
        Am Heart J. 1990; 119: 1262-1267
        • Stamler J.S
        • Osborne J.A
        • Jaraki O
        • Rabbani L.E
        • Mullins M
        • Singel D
        • Loscalzo J
        Adverse vascular effects of homocysteine are modulated by endothelium-derived relaxing factor and related oxides of nitrogen.
        J Clin Invest. 1993; 91: 308-318
        • Wall R.T
        • Harlan J.M
        • Harker L.A
        • Striker G.E
        Homocysteine-induced endothelial cell injury in vitro.
        Thromb Res. 1980; 18: 113-121
        • Starkebaum G
        • Harlan J.M
        Endothelial cell injury due to coppler-catalyzed hydrogen peroxide generation from homocysteine.
        J Clin Invest. 1986; 77: 1270-1276
        • Tawakoi A
        • Omland T
        • Gerhard M
        • Wu J.T
        • Creager M.A
        Hyperhomocyst(e)inemia is associated with impaired endothelium-dependent vasodilatation in humans.
        Circulation. 1997; 95: 1119-1121
        • Celermajer D.S
        • Sorensen K
        • Ryalls M
        • Robinson J
        • Thomas O
        • Leonard J.V
        • Deanfield J.E
        Impaired endothelial function occurs in the systemic arteries of children with homozygous homocystinuria but not their heterozygous parents.
        J Am Coll Cardiol. 1993; 22: 854-858
        • De Meyer G.R.Y
        • Herman A.G
        Vascular endothelial dysfunction.
        Prog Cardiovasc Dis. 1997; 39: 325-342
        • Donner M.G
        • Klein G.K
        • Mathes P.B
        • Schwandt P
        • Richter W.G
        Plasma total homocysteine levels in patients with early-onset coronary heart disease and a low cardiovascular risk profile.
        Metabolism. 1998; 47: 273-279