Abstract
Introduction
Despite recent meta-analyses suggesting that homocysteine is an independent predictor
of coronary heart disease (CHD), there is debate regarding whether elevated homocysteine
may be deleterious only in the presence of other risk factors, with which it acts
synergistically to exert a multiplicative effect on CHD risk, emerging only as a CHD
predictor in patients with pre-existing risk factors.
The Prospective Epidemiological Study of Myocardial Infarction (PRIME) Study is a
multicentre prospective study of 10 593 men from France and Northern Ireland, investigating cardiovascular risk factors.
We investigated: (1) whether higher homocysteine is associated with increased CHD
risk in the PRIME case-control cohort; (2) whether homocysteine interacts synergistically
with pre-existing CHD risk factors.
Methods
Homocysteine was measured in 323 participants who had developed CHD at 5-year follow-up
and in 638 matched controls.
Results
There was no significant difference in homocysteine between cases and controls (p = 0.18). Homocysteine was significantly higher in current smokers (geometric mean μmol/l
(interquartile range μmol/l) 9.45 (7.43, 11.75)) compared with non-smokers (8.90 (7.32,
10.70); p = 0.007). There was a significant interaction between homocysteine, smoking and CHD
risk (χ2 = 10.29, d.f. = 2, p = 0.006).
Conclusions
These findings suggest that elevated homocysteine is significantly associated with
CHD risk in current smokers.
Keywords
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Article info
Publication history
Published online: June 15, 2006
Accepted:
May 3,
2006
Received in revised form:
April 20,
2006
Received:
November 17,
2005
Identification
Copyright
© 2006 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
