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Published on: October 12, 2017
[Hyperhomocysteinemia as a risk factor for coronary atherosclerotic diseases in the elderly]
Claudia Felícia Gravina-Taddei1, Michel Batlouni, Camila Sarteschi
1Instituto Dante Pazzanese de Cardiologia, São Paulo, SP. clau-gravina@hotmail.com
Insights
High homocysteine levels (hyperhomocysteinemia) are an independent risk factor for coronary artery disease in elderly individuals. This finding highlights a significant link between elevated homocysteine and cardiovascular risk in older populations.
Area of Science:
- Cardiovascular Medicine
- Clinical Biochemistry
- Geriatrics
Context:
- Atherosclerotic disease poses a significant health challenge in elderly populations.
- Understanding modifiable risk factors is crucial for preventative strategies in aging individuals.
Purpose:
- To determine if hyperhomocysteinemia is an independent risk factor for atherosclerotic disease in the elderly.
- To quantify the association between homocysteine levels and coronary artery disease risk in this demographic.
Summary:
- A case-control study involving 172 elderly individuals (84 cases, 88 controls) assessed homocysteine levels.
- Multivariate analysis revealed hyperhomocysteinemia as an independent risk factor for coronary artery disease (CAD) in the elderly.
- Elevated homocysteine levels were significantly associated with increased CAD risk, with a risk rate of 2.03 for hyperhomocysteinemia.
Impact:
- Identifies hyperhomocysteinemia as a key, independent risk factor for CAD in the elderly.
- Suggests potential therapeutic targets for reducing cardiovascular risk in older adults.
- Emphasizes the importance of monitoring homocysteine levels in geriatric cardiovascular risk assessments.
Objective:
To investigate whether hyperhomocysteinemia is an independent risk factor for atherosclerotic disease in elderly individuals.
Methods:
A case-control study with 172 elderly individuals, 88 belonging to control group and 84 to case group, who showed coronary angiography requested for clinical indications. Quantitative coronary angiography was performed in 91% of the patients. Homocysteinemia was assessed in a continuous and categorized way, through univariate and multivariate analysis.
Results:
When analyzed continuously, in univariate analysis, it was verified that case group elderly individuals showed an average homocysteinemia levels significantly higher than the control group individuals' (14.33 +/- 4.59 micromol/l against 11.99 +/- 4.59 micromol/l, p = 0.015). In multivariate analysis, continuous homocysteinemia was associated to the risk rate for coronary artery disease of 1.07 for each 1 micromol/l increase of homocysteine level. Na increase of 5 micromol/l corresponded to the risk rate of 1.40. When analyzed in categorized way, the values found over percentile 75 of control group (14 micromol/l) were defined as hyperhomocysteinemia. Hyperhomocysteinemia was found in 34% of elderly individuals, being 37.3% in control group and 62.7% in case group (p = 0.009). In multivariate analysis, hyperhomocysteinemia constituted an independent risk factor for coronary atherosclerotic disease for elderly individuals, with a risk rate for coronary artery disease of 2.03, confidence interval 95%, 1.02-4.03.
Conclusion:
Hyperhomocysteinemia was an independent risk factor for coronary artery disease in elderly individuals.
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