Conditional risk factors in men with previous myocardial infarction: relevance of C3 and homocysteine.
OBJECTIVE
To establish which traditional and conditional risk factors were effectively treated, and which remained active, in patients with previous myocardial infarction (PMI).


RESULTS
In 47 PMI patients recently submitted to cardiological assessment and in 42 controls (50-70 years old men), traditional risk factors (total cholesterol, high-density lipoprotein cholesterol, blood glucose, blood pressure, cigarette smoking and body mass index) and the following variables were measured: fibrinogen, plasminogen activator inhibitor-1 (PAI-1), lipoprotein(a) [Lp(a)], total homocysteine, plasma folates, vitamin B12, high sensitivity C-reactive protein and C3 complement. Most patients were taking beta-blockers, ACE inhibitors and statins. Accordingly, patients had lower blood pressure and cholesterol values than controls. Moreover, they consumed less alcohol and coffee and did not differ from controls in cigarette smoking and body mass index. Conversely, patients had higher levels of homocysteine, fibrinogen, C3 complement and Lp(a), although of these factors only C3 and homocysteine remained significantly associated with PMI in multivariate analysis. C-reactive protein, PAI-1 and especially C3 often correlated with traditional risk factors in controls, but these correlations tended to disappear or reverse in PMI patients. Fibrinogen inversely correlated with alcohol consumption. Homocysteine correlated (inversely) with plasma folates only. Lp(a) did not correlate with any variable.


CONCLUSIONS
Forty-seven patients with previous myocardial infarction displayed an excellent control of traditional risk factors, but they had higher mean C3 and homocysteine levels than the control group.
Muscari
A
A
Department of Internal Medicine, Cardioangiology, Hepatology, University of Bologna, Italy. amuscari@med.unibo.it
Mele
M C
MC
Bastagli
L
L
Poggiopollini
G
G
Tomassetti
V
V
Drago
G
G
Legnani
C
C
Barini
A
A
Cappelletti
O
O
Boni
P
P
Puddu
P
P
D000368:Aged; D016022:Case-Control Studies; D003176:Complement C3 / Q000378:metabolism*; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000209:etiology*; D012307:Risk Factors; D018709:Statistics, Nonparametric
D003176:Complement C3; D006710:Homocysteine