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Homocysteine and nitric oxide in patients undergoing diagnostic coronary angiography

Nergis Domaniç1, Remise Gelişgen, Sabiha Civelek

  • 1Department of Cardiology, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul 34098, Turkey.

Acta Medica Okayama
|March 2, 2006
PubMed

Insights

Elevated homocysteine (tHcy) is linked to coronary artery disease (CAD) severity. In early atherosclerosis, high tHcy increases nitric oxide metabolites (NOx), but this compensatory effect diminishes as CAD progresses.

Area of Science:

  • Cardiovascular Medicine
  • Biochemistry
  • Clinical Research

Background:

  • Elevated plasma homocysteine (tHcy) is a potential risk factor for cardiovascular diseases.
  • Nitric oxide metabolites (NOx) play a crucial role in vascular homeostasis.
  • The relationship between tHcy, NOx, and coronary artery disease (CAD) progression requires further elucidation.

Purpose of the Study:

  • To investigate the association between plasma tHcy and NOx levels with the presence and severity of CAD.
  • To examine these associations in patients with and without acute coronary syndromes (ACS).
  • To evaluate the relationship between tHcy, NOx, and cardiovascular risk status.

Main Methods:

  • Cross-sectional study involving 79 patients undergoing diagnostic coronary angiography.
  • Measurement of plasma tHcy and NOx levels.
  • Correlation analysis of tHcy and NOx with CAD extent (number of diseased vessels), ACS presence, and patient risk stratification.

Main Results:

  • Hyperhomocysteinemia was more prevalent in CAD patients (37%) than controls (11%).
  • Patients with 3-vessel disease exhibited significantly higher tHcy levels compared to controls.
  • Highest tHcy concentrations were observed in patients with 3-vessel disease and ACS.
  • A positive correlation between tHcy and NOx was found in 1-vessel disease, but not in multi-vessel disease.
  • High-risk patients had higher tHcy and vessel involvement but lower NOx compared to low-risk patients.

Conclusions:

  • Hyperhomocysteinemia is associated with increased CAD severity and ACS.
  • In early atherosclerosis, hyperhomocysteinemia may trigger an increase in NOx production.
  • With disease progression, this compensatory NOx increase is lost, suggesting a shift in vascular response.

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