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Hyperhomocysteinemia is a risk factor of recurrent coronary event in young patients irrespective to the MTHFR C677T

J R Gonzalez-Porras1, F Martin-Herrero, R Garcia-Sanz

  • 1Department of Hematology, University Hospital of Salamanca, Paseo de San Vicente, 58-182, Salamanca, 37007, Spain. gonzapor@hotmail.com

Thrombosis Research
|September 29, 2006
PubMed

Insights

Elevated homocysteine levels in young adults after a first acute coronary syndrome increase the risk of recurrent coronary events. This finding highlights homocysteine as a key predictor, independent of MTHFR C677T gene variants.

Area of Science:

  • Cardiovascular Medicine
  • Clinical Biochemistry
  • Genetics

Background:

  • Hyperhomocysteinemia is a known risk factor for cardiovascular disease.
  • Limited data exists on its impact on recurrent coronary events (RCE) in younger populations.
  • Acute coronary syndrome (ACS) in patients under 55 necessitates understanding long-term risks.

Purpose of the Study:

  • To investigate the association between admission total homocysteine (tHcy) levels and RCE incidence in young ACS patients.
  • To evaluate the role of MTHFR C677T polymorphism as a risk factor for RCE.
  • To identify independent predictors of RCE in this demographic.

Main Methods:

  • Prospective follow-up of 140 patients (<55 years) post-first ACS for approximately 49 months.
  • Plasma tHcy levels measured at admission and categorized into quartiles.
  • Analysis included MTHFR C677T polymorphism screening and multivariate risk factor assessment.

Main Results:

  • 35% of patients experienced RCE during follow-up.
  • Higher tHcy levels (particularly quartile 4, >12.37 mumol/L) were significantly associated with increased RCE risk (HR=2.5).
  • Independent predictors of RCE included older age (>45 years), higher BMI (>25), and elevated tHcy levels.

Conclusions:

  • Elevated plasma tHcy at admission is an independent risk factor for RCE in young ACS patients.
  • MTHFR C677T polymorphism did not show an association with increased RCE incidence.
  • Homocysteine levels are crucial for risk stratification in young individuals post-ACS.

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