[Homocysteine and progression of carotid atherosclerosis in patients with coronary disease].
OBJECTIVE
Carotid intima-media thickness (IMT) is a marker of generalized atherosclerosis. Sequential evaluation of carotid IMT has permitted to know the factors involved in its progression. However, there are few studies about the influence of homocysteine in such progression. The aim of this work was to know the effect of homocysteine values on the evolution of carotid IMT in patients with coronary disease.


METHODS
Carotid IMT (baseline and after 4 years of follow-up) was evaluated by a B-mode ultrasonography in 187 patients with coronary disease (166 males and 21 females; age: mean [standard deviation], 60 [7] years); 185 patients were treated with statins from the beginning of the study.


RESULTS
Carotid IMT progression was confirmed in 59 patients (31.6%; 95% confidence interval [CI], 25.0-38.7%). Cardiovascular risk factors, basal biochemical parameters and methylenetetrahydrofolate reductase-C677T polymorphism were similar in patients with and without progression except for homocysteine values which were higher in the former (13.3 [5.3]; 95% CI, 12.0-14.6 vs 11.1 [3.5]; 95% CI, 10.5-11.7 (mol/l; p = 0.001). Biochemical changes at the end of the study were similar in both groups. In the multivariate analysis, IMT progression was associated with basal values of homocysteine (odds ratio [OR] 1.19; 95% CI, 1.07-1.31; p = 0.0008), female gender (OR 3.50; 95% CI, 1.17-10.50; p = 0.02), hypertension (OR 2.52; 95% CI, 1.14-5.59; p = 0.02) and basal high-density lipoprotein (HDL)-cholesterol values (OR, 0.94; 95% CI, 0.90-0.98; p = 0.009).


CONCLUSIONS
The concentration of homocysteine is associated with the progression of carotid atherosclerosis in patients with coronary heart disease treated with statins.
Fernández-Miranda
Consuelo
C
Unidad de Lípidos y Aterosclerosis. Servicio de Medicina Interna. Hospital Universitario 12 de Octubre. Madrid. Spain. cfmiranda@inicia.es
Paz
Manuel
M
Aranda
José Luis
JL
Núñez
Víctor
V
Gómez
Pilar
P
Díaz-Rubio
Pilar
P
Martínez
Joaquín
J
Gómez de la Cámara
Agustín
A
D001161:Arteriosclerosis / Q000097:blood* / Q000150:complications*; D002340:Carotid Artery Diseases / Q000097:blood* / Q000150:complications*; D003327:Coronary Disease / Q000150:complications*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged
D006710:Homocysteine