The association between homocysteine and myocardial infarction is independent of age, sex, blood pressure, cholesterol, smoking and markers of inflammation: the Glasgow Myocardial Infarction Study.
Homocysteine is associated with both myocardial infarction and arterial wall inflammation. To establish whether homocysteine is associated with myocardial infarction after adjusting for age, sex, the major cardiovascular risk factors and inflammatory risk predictors (fibrinogen, C-reactive protein and interleukin-6). A case-control study, using 364 myocardial infarction cases drawn from the north Glasgow MONICA study, 3-9 months after their event, and 383 controls drawn from the general population of the same geographical area. The odds ratio for myocardial infarction increased progressively across the four quarters of the homocysteine distribution, after adjusting for only age and sex or for the full adjustment (age, sex, smoking, systolic blood pressure, total cholesterol, fibrinogen, C-reactive protein and interleukin-6). The odds ratios produced by the two adjustments were similar. Comparing the top quarter with the bottom quarter of homocysteine, the odds ratio was 2.21 (95% confidence interval: 1.30-3.76) after the full adjustment. The odds ratio for a 5 micromol/l increase in homocysteine was 1.12 (95% confidence interval: 1.01-1.24) after the full adjustment.


CONCLUSIONS
This study suggests that homocysteine has an effect on cardiovascular risk over and above that of inflammatory markers and the major cardiovascular risk factors.
Woodward
Mark
M
The George Institute, Royal Prince Alfred Hospital, Sydney, Australia, and Department of Clinical Biochemistry, Division of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
Rumley
Alan
A
Rumley
Ann
A
Rumley
Christopher
C
Lewington
Sarah
S
Morrison
Caroline E
CE
Lowe
Gordon D O
GD
D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007249:Inflammation / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000209:etiology*; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000097:blood
D015415:Biomarkers; D006710:Homocysteine; D002784:Cholesterol