Plasma level of homocysteine is inversely-associated with the development of collateral circulation in patients with single-vessel coronary artery disease.
Homocysteine induces endothelial injury and inhibits endothelial cell proliferation, which is a key role in angiogenesis. The purpose of this study was to investigate whether the plasma level of homocysteine is associated with the development of collaterals in patients with single-vessel coronary artery disease (CAD). Among a series of 105 male patients with angiographic estimation, 49 with single-vessel CAD were intensively investigated. Development of collaterals was classified by Rentrop's method. Univariate and multivariate analyses revealed that hyperhomocysteinemia negatively affected the development of collaterals (p=0.0015 and 0.0011, odds ratio 0.69, 95% confidence interval 0.52-0.90), whereas the duration of angina and percent stenosis evaluated by quantitative coronary angiography had a positive affect. Moreover, the level of homocysteine in the group with poorly developed collaterals (n=7, Rentrop class 0 and 1) was significantly higher than that in the group with well-developed collaterals (n=12, Rentrop class 2 and 3) of the patients with single-vessel disease showing total occlusion (p=0.034). This study clearly demonstrates that the plasma level of homocysteine is independently and inversely associated with the development of collateral circulation in CAD patients. Homocysteine might be a new undesirable aspect of ischemic heart disease through its inhibition of collateral development.
Nagai
Yoshitaka
Y
2nd Department of Internal Medicine, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan.
Tasaki
Hiromi
H
Miyamoto
Masaharu
M
Nihei
Shun-ichi
S
Kobayashi
Kengo
K
Yamashita
Kazuhito
K
Tsutsui
Masato
M
Kouzuma
Ryouji
R
Okazaki
Masahiro
M
Nakashima
Yasuhide
Y
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D003097:Collateral Circulation / Q000502:physiology*; D003327:Coronary Disease / Q000097:blood* / Q000503:physiopathology; D023921:Coronary Stenosis / Q000097:blood / Q000503:physiopathology; D003404:Creatinine / Q000097:blood; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking
D015415:Biomarkers; D006710:Homocysteine; D003404:Creatinine