Determinants of plasma homocysteine in relation to hematological and biochemical variables in patients with acute myocardial infarction.
BACKGROUND
Elevated plasma total homocysteine (tHcy) is a risk factor for coronary artery disease (CAD), but the mechanism is not known. This study evaluates the determinants and associations of tHcy in patients presenting with acute myocardial infarction (AMI).


METHODS
Plasma concentration of tHcy, protein C, protein S, and antithrombin were measured in 210 (177 males and 33 females) patients with first AMI and 167 (87 males and 80 females) controls. Serum vitamin B12, folate, creatinine, lipid profile, fasting glucose, full blood count and red cell folate were determined. Creatinine clearance was calculated using the modification of diet in renal disease formula. Univariate and multivariate analyses were used to determine the associations of tHcy.


RESULTS
Mean tHcy was higher in male than female patients. On logistic regression analysis, the most important determinants oftHcy in the patients were age, creatinine, creatinine clearance, vitamin B12 and red cell folate. When study patients were compared with the controls, tHcy, fasting glucose and serum creatinine were significantly higher, while creatinine clearance and HDL cholesterol were significantly lower in the study patients. Logistic regression analysis showed significant association of tHcy with AMI, odds ratio = 1.39, in the presence of other confounding factors.


CONCLUSIONS
Our results show that tHcy is a significant risk factor for CAD in our patient population. The determinants in the patients are age, glomerular filtration rate and the status of vitamins B12 and folate. The above determinants should be kept in mind when using tHcy as a risk factor for CAD.
Marouf
Rajaa
R
Department of Pathology, Kuwait University, Faculty of Medicine. r-marouf@hsc.edu.kw
Zubaid
Mohammad
M
Mojiminiyi
Olusegun A
OA
Qurtom
Mohammad
M
Abdella
Nabila A
NA
Al Wazzan
Hanan
H
Al Humood
Salah
S
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001772:Blood Cell Count; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000150:complications; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D011379:Prognosis; D012307:Risk Factors; D012737:Sex Factors; D014815:Vitamins / Q000097:blood
D015415:Biomarkers; D014815:Vitamins; D006710:Homocysteine