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[Total plasma homocysteine concentrations in Puerto Rican patients with ischemic heart disease]
J F Rodríguez1, N Escobales, D Cruz
1Departamento de Bioquímica. Unidad de Biología Cardiovascular. Escuela de Medicina. Universidad de Puerto Rico. jrodriguez@rcm.upr.edu
Insights
Total plasma homocysteine (tHcys) levels in Puerto Ricans with atherosclerotic cardiovascular disease (ACD) were similar to the Framingham study. These findings suggest tHcys is not a reliable predictor of ACD severity in this population.
Area of Science:
- Cardiovascular Medicine
- Biochemistry
- Epidemiology
Context:
- Coronary heart disease is a leading cause of death globally, yet Puerto Rico exhibits lower incidence and severity compared to the continental US.
- Elevated total plasma homocysteine (tHcys) is a potential risk factor for cardiovascular disease.
- Investigating tHcys levels in the Puerto Rican population with atherosclerotic cardiovascular disease (ACD) is crucial for understanding regional health disparities.
Purpose:
- To measure total plasma homocysteine (tHcys) concentrations in a cohort of Puerto Rican patients diagnosed with atherosclerotic cardiovascular disease (ACD).
- To explore potential correlations between tHcys levels and the severity of ACD in this population.
- To compare tHcys levels in Puerto Rican patients with established data from continental US studies, such as the Framingham study.
Summary:
- Mean tHcys concentrations in 70 hospitalized Puerto Rican patients with ACD were comparable to the Framingham study after age adjustment.
- No significant differences in tHcys levels were observed between diabetic and non-diabetic patients, nor a direct correlation with the severity of coronary angiography findings.
- Male patients exhibited higher tHcys levels than female patients, though this difference approached but did not reach statistical significance (p=0.07).
Impact:
- The study indicates that total plasma homocysteine (tHcys) may not be a strong predictor for the clinical severity of atherosclerotic cardiovascular disease (ACD) in the Puerto Rican population.
- These findings contribute to a better understanding of cardiovascular disease risk factors and their specific relevance within diverse ethnic and geographic groups.
- Further research is warranted to identify other contributing factors to the lower incidence and severity of coronary disease observed in Puerto Rico.
Introduction And Objectives:
In Puerto Rico, it has been established that although coronary disease is the leading cause of death, the population has a lower incidence of coronary disease than in 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. One factor that could contribute to the lower incidence of coronary disease in Puerto Rico is that our population might have lower total plasma homocysteine concentrations (tHcys) than in the continental United States. Our main objective was to measure tHCys in the Puerto Rican population with atherosclerotic cardiovascular disease (ACD).
Methods:
We randomly measured tHcys concentrations in seventy Puerto Rican patients who were hospitalized at the Cardiovascular Center of Puerto Rico and the Caribbean (UPR Division).
Results:
The mean tHCys concentration in these patients is similar to those reported for the Framingham study when adjusted by age (11.2 vs. 11.8 micromol/l). In the Puerto Rican population, males had a higher tHcys concentration than females (11.7 vs 9.5 micromol/l, p = 0.07). In addition, we did not see an increase of tHcys concentrations in diabetic patients when compared with non-diabetics (10.1 vs. 11.2 micromol/l, p = 0.74). We did not see a direct correlation between tHcys concentrations and heart condition as measured by coronary angiography (normal = 11.1 micromol/l, light = 10.5 micromol/l, moderate = 10.9 micromol/l, severe = 10.5 micromol/l; Kruskal-Wallis = 0.45) either.
Conclusion:
These results suggest that tHcys concentration is not a good predictor of the seriousness of ACD in the Puerto Rican patient population.
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