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Total plasma homocysteine concentrations in Puerto Rican patients with presumptive atherosclerotic coronary disease
J F Rodríguez1, J L Rodríguez, N Escobales
1Department of Biochemistry, School of Medicine, University of Puerto Rico, San Juan. j_rodriguez@rcmaxp.upr.clu.edu
Insights
Total plasma homocysteine (tHcys) levels in Puerto Rico are similar to the Framingham study. However, tHcys concentration does not appear to predict coronary artery disease severity in this Hispanic population.
Area of Science:
- Cardiovascular Science
- Clinical Chemistry
- Epidemiology
Background:
- Coronary heart disease (CHD) is a leading cause of death in Puerto Rico, yet incidence and severity appear lower than in the continental US.
- Lower total plasma homocysteine (tHcys) concentrations may contribute to reduced CHD incidence in Puerto Rico.
Purpose of the Study:
- To investigate the relationship between tHcys concentrations and coronary atherosclerosis in a Hispanic population in Puerto Rico.
Main Methods:
- Randomly measured tHcys concentrations in 72 Hispanic patients undergoing coronary angiography.
- Analyzed tHcys levels in relation to age, sex, diabetes, and coronary atherosclerosis severity.
Main Results:
- Mean tHcys concentration (11.2 mumol/L) was comparable to the Framingham study (11.8 mumol/L) after age adjustment.
- No statistically significant differences in tHcys were found between males and females, diabetics and non-diabetics, or across varying degrees of atherosclerosis.
- No direct correlation was observed between tHcys levels and coronary angiography findings.
Conclusions:
- tHcys concentration is not a reliable predictor of atherosclerotic coronary disease in this Puerto Rican patient cohort.
- Further research is needed to understand the factors contributing to lower CHD incidence and severity in Puerto Rico.
Background:
In Puerto Rico, it has been established that although coronary heart disease is the leading cause of death, the population has a lower incidence of coronary disease than the continental United States. In addition, the severity of the disease is less aggressive in terms of a lower incidence of ventricular tachycardia and sudden death. A factor in the lower incidence of coronary disease in Puerto Rico could be a lower total plasma homocysteine concentration (tHcys) in our population.
Methods:
We randomly measured tHcys concentrations in seventy-two Hispanic patients who were hospitalized for coronary angiography at the Cardiovascular Center of Puerto Rico and the Caribbean (UPR Division).
Results:
The mean tHCys concentration in our patient population is similar than that reported for the Framingham study when adjusted by age (11.2 mumol/L vs. 11.8 mumol/L). In the Puerto Rican population, males had a higher tHcys concentration than females but this difference was not statistically significant (10.9 mumol/L vs. 9.4 mumol/L, p = 0.09). In addition, we did not see an increase of tHcys concentrations in diabetic patients when compared with nondiabetics (10.1 mumol/L vs. 10.3 mumol/L, p = 0.73). Neither we saw a direct correlation between tHcys concentrations and atherosclerosis as measured by coronary angiography (normal = 10.9 mumol/L, mild = 8.6 mumol/L, moderate = 10.9 mumol/L, severe = 10.5 mumol/L; ANOVA = 0.29).
Conclusions:
These results suggest that tHcys concentration is not a good predictor of atherosclerotic coronary disease in our patient population.
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