title: Plasma S-adenosylhomocysteine is associated with the risk of cardiovascular events in patients undergoing coronary angiography: a cohort study.
abstract: BACKGROUND
  Although cross-sectional studies have shown that plasma S-adenosylhomocysteine (SAH), the metabolic precursor of homocysteine, is associated with cardiovascular disease, the prospective relation between plasma SAH and cardiovascular disease risk is unknown.
  
  
  OBJECTIVE
  The aim of this study was to prospectively evaluate the association between plasma SAH and cardiovascular disease risk in coronary angiography patients.
  
  
  METHODS
  Baseline plasma SAH and homocysteine concentrations were measured in 1003 patients aged between 21 and 87 y who underwent coronary angiography. Cox proportional hazards models were used to analyze the association between SAH and homocysteine and the risk of cardiovascular events, including fatal cardiovascular diseases, nonfatal myocardial infarction, and stroke.
  
  
  RESULTS
  During the median follow-up period of 3.0 y, 93 participants developed cardiovascular events (32.7/1000 person-years). The age- and sex-adjusted hazard ratio of cardiovascular events was 3.38 (95% CI: 2.12, 5.39) for each 1-SD increase in the natural log-transformed SAH concentration. The age- and sex-adjusted hazard ratios of cardiovascular events across quartiles of SAH concentrations were 1.0, 2.25, 2.72, and 3.40 (P-trend = 0.007). Further adjustment for other cardiovascular disease risk factors and plasma homocysteine affected the results only slightly. This positive association between SAH and cardiovascular disease risk did not change when participants were stratified by age group, sex, and other baseline covariates. The results among a subset of participants with significant coronary stenosis were similar.
  
  
  CONCLUSIONS
  Higher concentrations of plasma SAH are independently associated with an increased risk of cardiovascular events among patients undergoing coronary angiography. This trial was registered at www.chictr.org as ChiCTR-RNRC-08000270.
authors.affiliation: Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, China (YX, MW, XL, DS, DL, YY, MX, and WL); the Department of Nutrition and Food Hygiene, Shenzhen Centre for Disease Control and Prevention, Shenzhen, Guangdong, China (YX); and the Department of Cardiology, Guangzhou Military General Hospital, Guangzhou, China (YZ and JQ).
authors.forename: Yunjun
authors.initials: Y
authors.lastname: Xiao
authors.forename: Yuan
authors.initials: Y
authors.lastname: Zhang
authors.forename: Min
authors.initials: M
authors.lastname: Wang
authors.forename: Xinrui
authors.initials: X
authors.lastname: Li
authors.forename: Dongfang
authors.initials: D
authors.lastname: Su
authors.forename: Jian
authors.initials: J
authors.lastname: Qiu
authors.forename: Dan
authors.initials: D
authors.lastname: Li
authors.forename: Yan
authors.initials: Y
authors.lastname: Yang
authors.forename: Min
authors.initials: M
authors.lastname: Xia
authors.forename: Wenhua
authors.initials: W
authors.lastname: Ling
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000209:etiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012435:S-Adenosylhomocysteine / Q000097:blood*; D020521:Stroke / Q000097:blood* / Q000209:etiology; D055815:Young Adult
chemical_list: D012435:S-Adenosylhomocysteine