Hyperhomocysteinemia is an independent risk factor in young patients with coronary artery disease in southern China

Abstract

Background: Elevated plasma homocysteine (Hcy) is considered to be a risk factor of coronary artery disease (CAD), although this is still controversially discussed. This study investigated the role of Hcy in young patients with CAD in southern China.

Methods: A total of 146 consecutive patients (aged ≤ 55 years) with angiographically proven CAD were enrolled in the study and 138 age-matched non-CAD individuals were included as the control group. Hcy levels were measured by enzymatic assay. Hyperhomocysteinemia (HHcy) was defined as Hcy ≥ 15 µmol/l. A 10-year CAD risk was calculated using the Framingham risk score (FRS) modified according to the National Cholesterol Education Program Adult Treatment Panel III.

Results: There were significant differences between the CAD and control groups with regard to male sex (P < 0.01), smoking history (P < 0.05), and triglyceride levels (TG, P < 0.05), but no remarkable difference in other conventional risk factors (all P > 0.05). Hcy and high-sensitivity C-reactive protein (hs-CRP) levels were significantly higher in the CAD group than those in the control group (both P < 0.05). The FRS and estimated 10-year absolute CAD event risk were low in both groups and did not show a statistical difference. Multivariate logistic regression showed that male sex (odds ratio, OR, 3.68; 95 % confidence interval, 95 % CI, 1.54-10.01), smoking (OR, 2.54; 95 % CI, 1.15-5.36), TG (OR, 1.30; 95 % CI, 1.08-3.06), hs-CRP (OR, 3.74; 95 % CI, 1.72-12.21), and HHcy (OR, 2.03; 95 % CI, 1.26-5.83) were independently correlated with CAD in young patients.

Conclusion: HHcy is an important independent risk factor for CAD in young patients in southern China after adjusting for other risk factors.