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Hyperhomocysteinemia: marker of systemic atherosclerosis in peripheral arterial disease

B-M Taute1, R Taute, S Heins

  • 1Department of Internal Medicine III/Angiology, Martin-Luther-University of Halle-Wittenberg, Halle/Saale, Germany. bettina.taute@med.izin.uni-halle.de

International Angiology : a Journal of the International Union of Angiology
|May 25, 2004
PubMed

Insights

Elevated homocysteine levels indicate a higher risk of systemic atherosclerosis in peripheral arterial disease (PAD) patients. This finding suggests hyperhomocysteinemia is a key prognostic marker for cardiovascular events in PAD.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Biology
  • Biochemistry

Background:

  • Peripheral arterial disease (PAD) is increasingly associated with hyperhomocysteinemia.
  • Symptomatic PAD often co-occurs with coronary, cerebrovascular, and renal artery disease, suggesting multilocular atherosclerosis.
  • Hyperhomocysteinemia may correlate with the extent of atherosclerosis.

Purpose of the Study:

  • To investigate the association between fasting total homocysteine concentrations and the extent/localization of atherosclerosis in PAD patients.
  • To determine if homocysteine levels predict systemic atherosclerosis in cerebrovascular, coronary, and renal vascular beds.

Main Methods:

  • 183 patients with PAD (Fontaine stages II-IV) were studied.
  • Patients were divided into isolated PAD (n=98) and systemic atherosclerosis (n=85) groups.
  • Renal insufficiency was an exclusion criterion; vascular characterization used non-invasive/invasive methods.

Main Results:

  • Homocysteine levels were significantly lower in isolated PAD patients (10.1±4.4 µmol/l) compared to those with systemic atherosclerosis (16.7±7.04 µmol/l).
  • Logistic regression identified elevated plasma homocysteine and reduced Ankle-Brachial Pressure Index (ABPI) as independent risk indicators for systemic atherosclerosis in PAD.
  • No significant differences were found in the localization or extent of concomitant systemic atherosclerosis between groups.

Conclusions:

  • Hyperhomocysteinemia serves as a precursoral marker for systemic atherosclerosis in PAD.
  • Elevated homocysteine is a prognostic indicator of cardiovascular morbidity and mortality in patients with PAD.
Abstract

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