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Homocysteine levels in patients with risk factors for atherosclerosis
A Blum1, S Lupovitch, K Khazim
1Department of Internal Medicine, Poria Hospital, Lower Galilee, Israel.
Insights
High homocysteine levels are common in patients with atherosclerosis risk factors. Measuring homocysteine is recommended for early detection and management of vascular disease risk.
Area of Science:
- Cardiovascular Science
- Metabolic Disorders
- Epidemiology
Background:
- Mild to moderate hyperhomocysteinemia is an established independent risk factor for atherosclerosis across various vascular beds.
- Elevated plasma total homocysteine is a significant predictor of mortality in patients with confirmed coronary artery disease.
Purpose of the Study:
- To assess homocysteine levels in individuals without diagnosed coronary artery disease but possessing at least one atherosclerosis risk factor.
- To determine the prevalence of hyperhomocysteinemia in a population at risk for atherosclerotic vascular disease.
Main Methods:
- Prospective collection of fasting blood samples from 160 consecutive patients (50 women, 110 men; mean age 65 years) with atherosclerosis risk factors but no documented coronary artery disease.
- Homocysteine levels were quantified using a standard immunoassay method.
Main Results:
- Nearly half (48.75%) of the patients studied exhibited elevated homocysteine levels.
- Specifically, 62 patients presented with mild hyperhomocysteinemia (15-30 micromol/l), and 16 had moderate hyperhomocysteinemia (30-100 micromol/l).
Conclusions:
- Hyperhomocysteinemia is highly prevalent in patients identified with risk factors for atherosclerosis.
- Routine measurement and appropriate treatment of homocysteine levels are advised for patients with atherosclerosis risk factors due to its role as a modifiable risk factor.
Background:
Abundant epidemiological evidence has demonstrated that the presence of mild to moderate hyperhomocysteinemia is an independent risk factor for atherosclerosis in the coronary, cerebral, and peripheral vasculature, and for vascular disease, including coronary disease. It has been demonstrated that plasma total homocysteine level is a strong predictor of mortality in patients with angiographically confirmed coronary artery disease.
Hypothesis:
The study was undertaken to determine the extent of homocysteine levels in patients without documented coronary artery disease, but with at least one risk factor for atherosclerosis.
Methods:
Fasting blood samples were collected prospectively from 160 consecutive patients (50 women and 110 men, mean age 65+/-7 years) who had at least one risk factor for atherosclerosis, but had no documented coronary artery disease. Homocysteine levels were measured by an immunoassay method.
Results:
Of the patients studied, 78 (48.75%) with at least one risk factor for atherosclerosis had high homocysteine levels; 62 patients had mild hyperhomocysteinemia (15-30 micromol/l); and 16 patients had moderate hyperhomocysteinemia (30-100 micromol/l).
Conclusions:
Our data suggest that hyperhomocysteinemia is highly prevalent in patients with risk factors for atherosclerosis. Homocysteine level (an independent convertible risk factor to atherosclerosis) should be measured routinely in patients with risk factors for atherosclerosis and treated appropriately.