SERUM HOMOCYSTEINE AS A RISK FACTOR FOR CORONARY HEART DISEASE

Authors

  • Ayesha Naureen
  • Bibi Munazza
  • Robina Shaheen
  • Shahbaz Ali Khan
  • Fozia Fatima

Abstract

Background: Homocysteine (Hcy) is an intermediate formed during the catabolism of sulphurcontaining essential amino acid, methionine and Less than one percent of tHcy is found as the freeform. Development of atherosclerotic changes and thrombo-embolism are common features inpatients with homocysteinuria. This study was conducted to assess the relationship of Hcy andcoronary heart disease (CHD) in our population. Methods: The cross-sectional analytical studywas carried out at the Department of Biochemistry, Hazara University Mansehra and AyubMedical College, Abbottabad. A total of 80 subjects were included in this study and were dividedinto 2 groups. Cases Group consisted of 40 patients who had confirmed Myocardial Infarction(MI) coming for routine follow-up (first re-visit) after the acute attack. Control Group consisted of40 matching healthy individuals. Demographic data including age, gender, dietary habits, heightand weight as documented in preformed proforma. Blood pressure was taken in sitting posture.Serum total Hcy were measured. Data was entered into computer using SPSS 16.0 for analysis.Results: The mean age of the cases was 59.68±8.06 (30–70) years and that of the controls was58.93±6.93 (48–76) years. The average BMI of cases was 27.70±3.61 Kg/m2 and of the controlswas 25.66±2.98 Kg/m2. This increase of BMI from controls to cases was statistically significant(p<0.050). The mean systolic BP of the cases was 153.88±11.90 mmHg in comparison with142.62±11.65 mmHg for the controls. This difference was statistically significant (p<0.001).Mean tHcy level of the cases was 17.15±4.45 μmol/l while that of controls was 12.20±2.53μmol/l. There is a statistically significant difference between cases and controls with respect toHcy levels (p<0.001). Conclusion: Plasma tHcy level has a powerful predictor value of CHD androutine screening for elevated Hcy concentrations is advisable especially for individuals whomanifest atherothrombotic disease without their traditional risk factors.Keywords: Hyperhomocysteinemia (HHcy), coronary heart disease (CHD)

References

Virdis A, Ghiadoni L, Salvetti G, Versari D, Taddei S, Salvett A.

Hyperhomocyst(e)inaemia: is this a novel risk factor in

hypertension. J Nephrol 2002;15:414–21.

Ceperkovic Z. The role of increased levels of Hcy in the

development of cardiovascular diseases. Med Preg 2006;59(3–

:143–7.

Kang SS, Wong PW, Cook HY, Norusis M, Messer JV. Proteinbound Hcy A possible risk factor for coronary artery disease. J

Clin Invest 1998;77:1482–6.

Fodor JG, LeGrand C. Homocyteine: a new coronary heart

disease risk factor. (CACRC) Canadian association of cardiac

rehabilitation; 1999. Retrieved on: 24-2-2003. Available at:

http://www.cacr.ca/news/1999/9909fodor.htm

Tofler GH, D’Agostino RB, Jacques PF, Bostom AG, Wilson

PW, Lipinska I, et al. Association between increased Hcy levels

and impaired fibrinolytic potential: Potential mechanism for

cardiovascular risk. Thromb Haemost 2002;88:799–804.

Genser D, Prachar H, Hauer R, Halbmayer M, Mlczoch J,

Elmadfa I. Hcy, folate and vitamin B12 in patients with coronary

heart disease. Ann Nutr Metab 2006;50:413–9.

Stanger O, Semmelrock HJ, Wonisch W, Bos U, Pabst E,

Wascher TC. Effects of folate treatment and Hcy lowering on

resistance vessel reactivity in atherosclerotic subjects. J

Pharmacol Exp Ther 2002;303:158–62.

Knekt P, Reunanen A, Alfthan A. Hyper Hcymia Arch Intern

Med 2001;161:1589–94.

Nishtar S. Prevention of coronary heart disease in South Asia.

Lancet 2002;360(9338):1015–8.

Ayub M, Tariq W, Nadeem MA, Irshad H, Khalid AW, Imam F,

et al. Risk stratification of patients presenting with first acute

myocardial infarction with serum cardiac troponin-T. Pak J

Cardiol 1999;10:54–62.

Okada E, Oida K, Tada H, Asazuma K, Eguchi K, Tohda G, et

al. Hyperhomocysteinemia is a risk factor for coronary

arteriosclerosis in Japanese patients with type 2 diabetes.

Diabetes Care 1999;22:484–90.

Aamir M, Sattar A, Dawood MM, Dilawar M, Ijaz A, Anwar M.

Hyperhomocystenimia as a risk factor for ischemic heart disease.

J Coll Physicians Surg Pak 2004;14:518–21.

Salah uddin M, Karira KA, Motahir AS, Samad A. Serum Hcy in

patients with acute myocardial infarction. Pak J Cardiol

;11:93–9.

J Ayub Med Coll Abbottabad 2012;24(1)

http://www.ayubmed.edu.pk/JAMC/24-1/Ayesha.pdf

Homocyteine Studies Collaboration. Homocysteine and risk of

Ischemic Heart Disease and stroke: a meta-analysis. JAMA

;288:2015–22.

Boushey CJ, Beresford SA, Omenn GS, Motulsky AG. A

quantitative assessment of plasma homocysteine as a risk factor

for vascular diseases: probable benefits of increasing folic acid

intake. JAMA 1995;274:1049–57.

Kaul S, Zadeh AA, Shah PK. Homocysteine hypothesis for

athrothrombotic cardio vascular disease. J Am Coll Cardiol

;48:914–23.

Shenoy KT, Lena KB, Sali N, Syam S, Shenoy ST,

Rajadhyaksha VD, et al. Rationale and design for the

CARDIOVIT Study (Cardiovit, Atherosclerotic vascular disease

and hyperhomocysteinemia: an epidemiological study in Indians,

additionally evaluating the effect of Oral vitamin

supplementation). Curr Med Res Opin 2006;22:641–8.

Refsum H, Yajnik CS, Gadkari M, Schneede J, Vollset

SE, Orning L. Hyperhomocysteinemia and elevated

methylmalonic acid indicate a high prevalence of cobalamin

deficiency in Asian Indians. Am J Clin Nutr 2001;74:233–41.

Chandalia M, Abate N, Cabo-Chan AV, Devaraj S, Jialal I,

Grundy SM. Hyperhomocysteinemia in Asian Indians living in

the United States. J Clin Endocrinol Metab 2003;88:1089–95.

Giray B, Aydan C, Sibel B, Baysal K, Ercument C, Oktay B.

Homocysteine levels and other risk factors in coronary heart

disease. Turk J Med Sci 2001;31:425–8.

Wein DG, McPartlin J, Scolt JM. Hcy and ischemic heart

disease: Results of a prospective study with implication regarding

prevention. Arch Intern Med 1998;158:862–8.

Welch GN, Loscalzo J. Homocysteine and atherothrombosis. N

Engl J Med 1998;338(15):1042–50.

Verhoef P. Hyperhomocysteinemia and risk of vascular disease

in women. Semin Thrombo Hemost 2002;26(3):325–34.

van Guldener C, Nanayakkara PW, Stehouwer CD.

Homocysteine and blood pressure. Curr Hypertens Rep

;5(1):26–31.

Published

2012-03-01

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