Hyperhomocysteinaemia & folic acid supplementation in patients with high risk of coronary artery disease.
OBJECTIVE
Many traditional independent risk factors such as diabetes mellitus, hypertension, hypercholesterolaemia, smoking, male sex, old age, etc., contribute to the development of coronary artery disease (CAD). Hyperhomocysteinaemia is an independent risk factor of CAD but the role of plasma homocysteine (Hcy) in high risk patients (> or = 3 risk factors) is not known. We investigated the role of plasma Hcy, folic acid, vitamin B12 in patients with high risk (> or = 3 risk factors) of CAD and effects of supplementation of folic acid in the patients with hyperhomocysteinaemia.


METHODS
The plasma Hcy levels in 152 patients with > or = 3 risk factors of CAD and 136 patients with 1-2 risk factors and 48 individuals with no risk factors were measured using high performance liquid chromatography (HPLC) with fluorescence detection. Plasma folic acid and vitamin B12 levels were also measured in these patients with immunoassays. The patients with hyperhomocysteinaemia were treated with 5 mg of folic acid for 8 wk, and plasma levels of Hcy were measured after treatment.


RESULTS
The plasma Hcy level was significantly higher in the patients with > or = 3 risk factors of CAD than in those with 1-2 risk factors and controls. The plasma levels of folic acid and vitamin B12 were significantly lower in the patients with > or = 3 risk factors of CAD compared to those with 1-2 risk factors and controls. The Hcy levels in the patients with > or = 3 risk factors of CAD significantly reduced by 33.5 per cent after 8 wk folic acid administration.


CONCLUSIONS
Plasma Hcy level was elevated significantly in patients with > or = 3 risk factors of CAD. Hyperhomocysteinaemia appears to play an important role in the pathogenesis of CAD. Folic acid supplementation may be useful in reducing plasma Hcy level in high risk patients with hyperhomocysteinaemia.
Department of Cardiology, Sir Run Run Shaw Hospital, Medical College, Zhejiang University, Hangzhou 310016, China. ghangyuan@hotmail.com
Hangyuan
H
Guo
Jong-Dae
JD
Lee
Takanori
T
Ueda
Jianfeng
J
Cheng
Jiang
J
Shan
Jian'an
J
Wang
D000328:Adult; D000368:Aged; D002851:Chromatography, High Pressure Liquid; D003324:Coronary Artery Disease / Q000473:pathology* / Q000517:prevention & control*; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000378:metabolism*; D006710:Homocysteine / Q000097:blood; D006801:Humans; D020138:Hyperhomocysteinemia / Q000209:etiology*; D007118:Immunoassay; D008297:Male; D008856:Microscopy, Fluorescence; D008875:Middle Aged; D012307:Risk Factors; D013997:Time Factors; D014805:Vitamin B 12 / Q000096:biosynthesis
D006710:Homocysteine; D005492:Folic Acid; D014805:Vitamin B 12