Abstract
An elevated plasma total homocysteine (tHcy) level is considered a risk factor for
coronary artery disease (CAD), but the relationship between plasma tHcy and well-defined
CAD in women is still unclear. Plasma tHcy concentrations and the covariates serum
folate, vitamin B12, and creatinine were analysed in 157 angiographically examined
postmenopausal women with unstable CAD and in 101 healthy controls. At coronary angiography,
16% had normal vessels and 84% had coronary atherosclerosis. Mean plasma tHcy concentration
(μmol/l, 95% confidence interval) did not differ in patients compared to controls
(13.1 (12.3–13.8) vs. 12.5 (11.6–13.5)) or in patients with or without coronary atherosclerosis
(13.3 (12.4–14.1) vs. 12.0 (10.8–13.2)). A trend to an increasing plasma tHcy with
increasing degree of coronary atherosclerosis was attenuated after adjustment for
age and the previous mentioned covariates. Odds ratio for the risk of coronary artery
disease and coronary atherosclerosis in hyperhomocysteinemic patients (≥90th percentile
in controls) was approximately 3. However, the confidence interval included unity
in half of the groups and the significance was therefore difficult to judge. Receiver
operating characteristics showed age to be the only variable with a significant discriminatory
ability regarding the presence of coronary atherosclerosis (area 0.77). Mild hyperhomocysteinemia
seems not to be related to the risk of unstable CAD in postmenopausal women. The trend
towards higher plasma tHcy with increasing degree of coronary atherosclerosis may
be a marker of the disease. In future studies adjustment for age and the other three
covariates should be considered.
Keywords
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Article info
Publication history
Published online: August 16, 2004
Accepted:
September 29,
1999
Received in revised form:
September 13,
1999
Received:
April 12,
1999
Identification
Copyright
© 2000 Elsevier Science Ireland Ltd. Published by Elsevier Inc. All rights reserved.
