title: Lipoprotein(a) and homocysteine potentiate the risk of coronary artery disease in male subjects.
abstract: BACKGROUND
  Lipoprotein (Lp(a)) and homocysteine (Hcy) are independent risk factors for coronary artery disease (CAD). Hcy promotes the release of free apo(a) from Lp(a). The high fibrin affinity of free apo(a) inhibits plasminogen binding and plasmin generation. Hyperhomocysteinemia can result from a less active variant of methylene tetrahydrofolate reductase (variant C677T). Because the C677T genotype is estimated to be present in 32.2% of the Mexican population, we took advantage of this prevalence to determine the possible potentiating effect between high plasma Lp(a) and Hcy for increasing the risk of CAD in male patients.
  
  
  RESULTS
  First, 222 male patients admitted for coronary angiography were recruited and classified as CAD+ or CAD-. Anthropometric measurements, traditional risk factors, and plasma total Hcy (tHcy) and Lp(a) levels were recorded in both groups. We performed a conditional logistic regression model adjusted for conventional risk factors of CAD and it became clear that Lp(a) ≥30mg/dl was a risk factor for CAD (odds ratio [OR] 5.06, 95% confidence interval [CI] 1.88-13.51, P=0.001), whereas Hcy was not related to CAD (OR 0.44, 95% CI 0.63-2.90, P=0.44). However, when both factors were considered together in an interaction model, high tHcy and high Lp(a) plasma concentrations showed a potentiated effect (OR 10.52, 95% CI 2.18-50.71, P=0.003).
  
  
  CONCLUSIONS
  The combination of high Lp(a) and Hcy levels synergistically increases the likelihood of developing CAD in male patients.
authors.affiliation: Instituto Nacional de Cardiología Ignacio Chávez, Grupo Genética Intervencionista, Departamentos de Biología Molecular, Hemodinámica, Endocrinología, Unidad Coronaria, Juan Badiano 1, México.
authors.forename: Manuel Alfonso
authors.initials: MA
authors.lastname: Baños-González
authors.forename: Eduardo
authors.initials: E
authors.lastname: Anglés-Cano
authors.forename: Guillermo
authors.initials: G
authors.lastname: Cardoso-Saldaña
authors.forename: Marco Antonio
authors.initials: MA
authors.lastname: Peña-Duque
authors.forename: Marco Antonio
authors.initials: MA
authors.lastname: Martínez-Ríos
authors.forename: Benjamin
authors.initials: B
authors.lastname: Valente-Acosta
authors.forename: Héctor
authors.initials: H
authors.lastname: González-Pacheco
authors.forename: Aurora
authors.initials: A
authors.lastname: de la Peña-Díaz
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D017270:Lipoprotein(a) / Q000097:blood*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D017270:Lipoprotein(a); D006710:Homocysteine