title: Homocysteine and progression of coronary artery disease.
abstract: BACKGROUND
  Hyperhomocysteinemia is one of the newly recognised risk factors of coronary artery disease (CAD). The role of hyperhomocysteinemia in the development of atherosclerosis has been controversial.
  
  
  OBJECTIVE
  To assess homocysteine (Hcy) plasma concentration in patients with CAD and to correlate Hcy level with some cardiovascular risk factors.
  
  
  METHODS
  The study group consisted of 150 males aged <55 years (mean age 49.5+/-5.7 years) with stable CAD. Lipid and carbohydrate profiles as well as Hcy, folic acid and vitamin B(12) serum concentration were assessed, and correlated with such cardiovascular risk factors as cigarette smoking, hypertension, obesity and a history of myocardial infarction.
  
  
  RESULTS
  Mean Hcy plasma concentration was 11.81+/-3.75 micro mol/L. In patients with Hcy >11.21 micro mol/L (median value) a lower level of folic acid and vitamin B12 as well as reduced ejection fraction and glomerular filtration rate were found when compared to patients with Hcy level <11.21 micro mol/L. In addition, creatinine concentration, mean patient's age, proportion of patients who smoked cigarettes and the number of affected coronary arteries were significantly higher in patients with an increased level of Hcy. The Hcy plasma concentration positively correlated with the progression of hypertension, creatinine level and the number of coronary vessels with stenosis. A significant negative correlation between Hcy and folic acid as well as vitamin B12 concentrations was documented. In patients with a three-vessel CAD, Hcy concentration was 12.46+/-3.85 micro mol/L and was significantly higher (p<0.03) compared with patients with a less advanced CAD. In the group of patients with diabetes the mean Hcy concentration increased with the number of affected coronary vessels (p<0.02) and reached the highest values in patients with a three-vessel CAD (15.38+/-7.28 micro mol/L).
  
  
  CONCLUSIONS
  There is a significant relationship between homocysteine plasma concentration and the incidence as well as progression of CAD. This association is particularly evident in patients with diabetes.
authors.affiliation: Department of Cardiology, Medical Academy, Białystok, Poland.
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Skibińska
authors.forename: Robert
authors.initials: R
authors.lastname: Sawicki
authors.forename: Anna
authors.initials: A
authors.lastname: Lewczuk
authors.forename: Jolanta
authors.initials: J
authors.lastname: Prokop
authors.forename: Włodzimierz
authors.initials: W
authors.lastname: Musiał
authors.forename: Irina
authors.initials: I
authors.lastname: Kowalska
authors.forename: Barbara
authors.initials: B
authors.lastname: Mroczko
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D003324:Coronary Artery Disease / Q000097:blood* / Q000503:physiopathology; D018450:Disease Progression; D005492:Folic Acid / Q000097:blood; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology; D009765:Obesity / Q000503:physiopathology; D012107:Research Design; D012307:Risk Factors; D012907:Smoking / Q000503:physiopathology; D014805:Vitamin B 12 / Q000097:blood
chemical_list: D001786:Blood Glucose; D008055:Lipids; D006710:Homocysteine; D005492:Folic Acid; D014805:Vitamin B 12