Association between plasma homocysteine levels and coronary artery disease: a population-based study in northern Greece.
OBJECTIVE
Elevated plasma total homocysteine (tHcy) levels constitute a risk factor for coronary artery disease (CAD). We prospectively examined the association of fasting tHcy levels in patients in Northern Greece who had established CAD.


METHODS
Plasma fasting tHcy levels were measured in 42 patients with angiographically documented CAD and compared to 42 age-, sex-, BMI- and smoking habit-matched control subjects. We also determined the plasma vitamin B(12), folic acid and lipoprotein levels in all patients and controls. Conventional risk factors for CAD were also estimated.


RESULTS
In a univariate analysis, tHcy (micromol/l) levels were higher in patients compared to controls almost reaching statistical significance (13 (7-41) vs 11.3 (4-39); p= 0.07). Multivariate analysis of conventional risk factors showed that tHcy levels were not an independent risk factor for CAD. However, tHcy levels were significantly higher in patients with a previous history of myocardial infarction compared to patients without such a history and to controls (15 (8.8-29) vs 11.7 (7-41); p = 0.007 and 15 (8.8-29) vs 11.3 (4-39); p = 0.002, respectively). Hyperhomocysteinaemia (> 15 micromol/l) was detected in 35.7% of patients and 11.9% of controls (p < 0.05).


CONCLUSIONS
In Northern Greece, plasma tHcy levels may not be an independent risk factor for CAD in patients with angiographically documented CAD. However, patients with CAD have a trend towards higher tHcy levels. Additionally, plasma tHcy levels may be associated with the development of myocardial infarction.
Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece.
Amalia I
AI
Boufidou
Areti D
AD
Makedou
Dimitrios N
DN
Adamidis
Haralampos I
HI
Karvounis
John T
JT
Gourassas
Haralampos T
HT
Kesidis
Kali G
KG
Makedou
Christodoulos E
CE
Papadopoulos
Georgios E
GE
Parharidis
Georgios E
GE
Louridas
D000328:Adult; D000368:Aged; D015415:Biomarkers; D016022:Case-Control Studies; D003327:Coronary Disease / Q000097:blood* / Q000453:epidemiology; D005260:Female; D006115:Greece / Q000453:epidemiology; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D016015:Logistic Models; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors
D015415:Biomarkers; D006710:Homocysteine