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Published on: January 28, 2020
Plasma homocysteine levels in patients with isolated coronary artery ectasia
Hasan Turhan1, Ali Riza Erbay, Ayse Saatci Yasar
1Inonu University, Medical Faculty, Department of Cardiology, 06520 Malatya, Turkey. drhturhan@yahoo.com
Insights
This study found a significant association between elevated plasma homocysteine levels and coronary artery ectasia (CAE). Further research is needed to confirm hyperhomocysteinemia
Area of Science:
- Cardiovascular Medicine
- Clinical Biochemistry
Background:
- Hyperhomocysteinemia is a known risk factor for arterial diseases.
- Previous studies linked elevated homocysteine to peripheral arterial aneurysms.
- The association between homocysteine and coronary artery ectasia (CAE) remained unexplored.
Purpose of the Study:
- To investigate plasma homocysteine levels in patients with isolated CAE.
- To determine if hyperhomocysteinemia is associated with CAE.
Main Methods:
- Compared 32 patients with isolated CAE to 30 controls with normal coronary arteries.
- Measured fasting plasma homocysteine using Fluorescence Polarization Immunoassay.
- Defined hyperhomocysteinemia as levels above 13.6 mumol/l (95th percentile of controls).
Main Results:
- 59% of CAE patients had hyperhomocysteinemia versus 7% in controls (p<0.001).
- CAE patients showed significantly higher homocysteine levels (14.9+/-4.5 vs. 8.6+/-1.9 mumol/l, p<0.001).
- A positive correlation was found between ectatic segment number and homocysteine levels (r=0.537, p=0.002).
Conclusions:
- This study establishes a novel association between elevated plasma homocysteine and isolated CAE.
- Larger prospective studies are required to validate the role of hyperhomocysteinemia in CAE.
- The potential benefit of homocysteine-lowering therapies for CAE warrants investigation.
Objective:
Hyperhomocysteinemia is recognized as an independent risk factor for arterial disease including coronary artery disease, cerebrovascular disease and peripheral vascular disease. Previously, an association between increased plasma homocysteine level and peripheral arterial aneurysms has been reported. However, the relationship between coronary artery ectasia (CAE) and plasma homocysteine level has not been investigated. Accordingly, this study was designed to investigate plasma homocysteine level in patients with isolated CAE.
Methods:
Thirty-two patients with isolated CAE without significant stenosis and 30 control subjects with angiographically normal coronary arteries were included in this study. Fasting plasma homocysteine concentrations were measured by Fluorescence Polarization Immunoassay method using homocysteine kids. Hyperhomocysteinemia is defined as plasma homocysteine levels above the 95th percentile of the control subjects (13.6 mumol/l).
Results:
According to the definition of hyperhomocysteinemia, 19 (59%) of patients with isolated CAE had elevated levels of plasma homocysteine compared to 2 (7%) in the control subjects with angiographically normal coronary arteries (p<0.001). In addition, patients with isolated CAE had significantly higher levels of plasma homocysteine compared to control subjects (14.9+/-4.5 micromol/l vs. 8.6+/-1.9 micromol/l respectively, p<0.001). Besides, we detected a significant positive correlation between the number of ectasic segment and plasma homocysteine level (r=0.537, p=0.002).
Conclusion:
We have shown for the first time an association between elevated plasma homocysteine level and isolated CAE. Larger prospective studies are needed to confirm the role of hyperhomocysteinemia in CAE and to evaluate the usefulness of homocysteine-lowering therapies.
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