Hyperhomocysteinemia as a risk factor for ischemic heart disease

Arteriosclerosis, Thrombosis, and Vascular Biology, 1998

A high serum total homocysteine (tHcy) level is an independent risk factor for cardiovascular disease. Because it is not known whether the strength of the association between hyperhomocysteinemia and cardiovascular disease is similar for peripheral arterial, coronary artery, and cerebrovascular disease, we compared the three separate risk estimates in an age-, sex-, and glucose tolerance-stratified random sample (nϭ631) from a 50-to 75-year-old general white population. Furthermore, we investigated the combined effect of hyperhomocysteinemia and diabetes mellitus with regard to cardiovascular disease. The prevalence of fasting hyperhomocysteinemia (Ͼ14.0 mol/L) was 25.8%. After adjustment for age, sex, hypertension, hypercholesterolemia, diabetes, and smoking, the odds ratios (ORs; 95% confidence intervals) per 5 -mol/L increment in tHcy were 1.44 (1.10 to 1.87) for peripheral arterial, 1.25 (1.03 to 1.51) for coronary artery, 1.24 (0.97 to 1.58) for cerebrovascular, and 1.39 (1.15 to 1.68) for any cardiovascular disease. After stratification by glucose tolerance category and adjustment for the classic risk factors and serum creatinine, the ORs per 5 -mol/L increment in tHcy for any cardiovascular disease were 1.38 (1.03 to 1.85) in normal glucose tolerance, 1.55 (1.01 to 2.38) in impaired glucose tolerance, and 2.33 (1.11 to 4.90) in non-insulin-dependent diabetes mellitus (Pϭ.07 for interaction). We conclude that the magnitude of the association between hyperhomocysteinemia and cardiovascular disease is similar for peripheral arterial, coronary artery, and cerebrovascular disease in a 50-to 75-year-old general population. High serum tHcy may be a stronger (1.6-fold) risk factor for cardiovascular disease in subjects with non-insulin-dependent diabetes mellitus than in nondiabetic subjects. (Arterioscler Thromb Vasc Biol. 1998;18:133-138.)

IOP Conference Series: Materials Science and Engineering

Cardiovascular disease (CVD) is the main cause of death worldwide. Among multiple cardiovascular risk factors, such as age, blood pressure, diabetes, smoking and hyperlipidemia, hyperhomocysteinemia has recently emerged to have an important role in increasing risk of CVD by impairing oxidative stress-induced endothelial dysfunction and inducing atherothrombosis. However, the association between high circulating level of homocysteine and increasing the risk of CVD in human remains controversial and has not been consistently observed. OBJECTIVES: The aim of this study is to evaluate the association between serum total homocysteine (tHcy) concentrations with increased risk of CAD in patients with acute myocardial infarction (MI) in Kurdish population. In addition, correlations of classical risk factors including hypertension, smoking, diabetes and hyperlipidemia with hyperhomocysteinemia in MI patients were studied. Its role in in development of CVD could be pivotal. METHODS: In a case...

Atherosclerosis, 1999

It is not clear to what extent methylenetetrahydrofolate reductase (MTHFR) gene and hyperhomocysteinemia effect the severity and extent of coronary atherosclerosis in Asian populations. We examined the MTHFR genotypes and plasma homocysteine (HCY) concentrations in 192 Taiwanese and investigated their relationship with coronary artery disease (CAD), and the severity and extent of coronary atherosclerosis. The distribution of MTHFR genotypes was similar in 116 CAD patients and 76 non-CAD subjects. Homozygosity was noted in 8% of CAD patients and 13% of non-CAD subjects (P = 0.33; 95% CI, 0.2 -1.6). The geometric mean of HCY values was higher in CAD patients (11.10 91.51 mmol/l) than in non-CAD subjects (9.21 91.55 mmol/l) (P= 0.003). HCY levels were higher in patients with multi-vessel disease (P B 0.05) or in patients with ]90% stenotic lesions (P=0.005), compared with non-CAD subjects. The CAD risks in the top two HCY quartiles ( ] 14.0 and 10.1 -13.9 mmol/l) were 4.0 (95% CI, 1.7-9.2) and 3.2 (95% CI, 1.4-7.4) times higher than in the lowest quartile (5 7.9 mmol/l) (P = 0.001 and 0.007, respectively). Linear regression analysis showed significant correlations between HCY concentrations and the severity and extent of atherosclerosis (P=0.0001 for both). In conclusion, hyperhomocysteinemia appears to have a graded effect on the risk of CAD as well as the severity and extent of coronary atherosclerosis. Our findings do not support the homozygous genotype of MTHFR as a genetic risk factor for CAD in this Taiwanese population. Perhaps a further study including assessment of vitamin status is needed to better clarify the relationship between MTHFR genotypes and CAD. : S 0 0 2 1 -9 1 5 0 ( 9 9 ) 0 0 2 0 8 -7

Interventional Medicine and Applied Science, 2013

Homocysteine (Hcy), a sulfur-containing amino acid that is formed by demethylation of dietary methionine to cystein. Elevated homocysteine level is known to be associated with coronary artery disease. We present a case of acute myocardial infarction in a 25-year-old woman, associated with hyperhomocysteinaemia. Her other risk factors for coronary artery disease were smoking, a moderately high LDL level, and a family history of sudden cardiac death. This case illustrates the need to include plasma homocysteine measurement in the setting of acute coronary syndromes in women with premature atherosclerosis, even in the presence of traditional risk factors for coronary artery disease.

Medical Laboratory Journal, 2024

Background: A higher occurrence of raised homocysteine levels has been reported in individuals with type 2 diabetes (T2D), particularly those with macroangiopathy and nephropathy. Given that hyperhomocysteinemia is a risk factor for T2D, mitigating this condition could potentially benefit T2D patients. This study aimed to investigate the influence of homocysteine on T2D and cardiovascular disease (CVD), as well as the factors that modify homocysteine levels. Methods: This cross sectional, observational study was conducted on 122 individuals in a tertiary care center in Western India. Data related to anthropometry, demography, and biochemistry were gathered following established standards. Statistical analysis was performed using Chi-square test. A P-value of <0.05 was considered statistically significant. Results: The findings indicated a significantly larger percentage of hyperhomocysteinemia in males, smokers, and individuals with elevated fasting blood sugar and HbA1c levels. The proportion of subjects with high homocysteine levels was notably greater in those with high total cholesterol and triglyceride levels. A significant correlation was observed between increased serum homocysteine levels and decreased serum folic acid and vitamin B12 levels in patients with ischemic heart disease. Conclusion: Elevated homocysteine levels are observed in smokers and diabetic patients, potentially leading to CVD. Furthermore, this study found a correlation between an increase in serum homocysteine levels and a decrease in serum folic acid and vitamin B12 levels in patients with ischemic heart disease.

To investigate whether hyperhomocysteinemia is an independent risk factor for atherosclerotic disease in elderly individuals.

Thrombosis Research, 2009

2004

Objective: To examine the association between hyperhomocysteinemia and the risk of coronary heart disease and to highlight the relation between hyperhomocysteinemia and other risk factors of coronary heart disease including smoking, hypertension, and hypercholesterolemia. Methods: A total of 45 patients with coronary heart disease and 35 healthy controls of either sex, aged 60 years or less, were examined. Blood samples were obtained from all subjects at fasting and 4 hours after a methionine-loading test. The risk for hyperhomocysteinemia and its relation to other risk factors were examined by logistic regression analyses. Results: Sixty percent of the patients had hyperhomocysteinemia (fasting and postload) as compared to 40% of the controls. The odds ratio for coronary heart disease in patients with elevated fasting and postload homocysteine was 1.85 (C.I = 1.3-2.5, p=0.00) and 1.24 (C.I =1.1-1.39, p=0.00) respectively. No interaction between hyperhomocysteinemia and other conventional risk factors was observed. The likelihood of a coronary heart disease event increased approximately by 2-fold in patients with elevated fasting homocysteine levels, and by 1.24-fold in those with elevated postload homocysteine levels. Only smoking and hyperhomocysteinemia were strong predictors for coronary heart disease among our study group. Conclusion: Hyperhomocysteinemia is significantly and independently associated with coronary heart disease in our Jordanian sample.

Journal of Hypertension, 2006

Objective The impact of homocysteine on cardiovascular disease can be more detrimental in women than in men, but it is unknown whether this applies to high-risk women. We therefore investigated the association of hyperhomocysteinemia with coronary artery disease (CAD) and cardiovascular mortality in high-risk women referred for CAD, both in the total population and in the hypertensive and normotensive cohorts.

World Journal of Cardiovascular Diseases, 2020

Homocysteine is sulfur containing intermediary amino acid formed by the demethylation of dietary methionine to cysteine. The raised serum homocysteine level is one of the important risk factors associated with coronary artery disease. We present a 23-year-old male with no other risk factors of coronary artery disease presented to us with acute anterior wall myocardial infarction and was treated with primary percutaneous coronary intervention. During the routine work up post percutaneous coronary intervention significant elevation of serum homocysteine level was seen with markedly low serum vitamin B12 level and was treated for it along with standard therapy for acute myocardial infarction. The case illustrates the need to incorporate a plasma homocysteine level during work up of coronary artery disease especially in young patients, more importantly in those without any conventional risk factors.