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[Homocysteinemia and coronary artery disease: a case-control study in a Tunisian population]
Insights
Elevated homocysteine levels, a condition known as hyperhomocysteinemia, are more prevalent in Tunisian coronary heart disease patients. This study suggests hyperhomocysteinemia is an independent risk factor for coronary heart disease.
Area of Science:
- Cardiovascular Medicine
- Nutritional Biochemistry
- Epidemiology
Context:
- Coronary heart disease (CHD) is a leading cause of mortality worldwide.
- Hyperhomocysteinemia, elevated homocysteine levels, is a potential risk factor for cardiovascular diseases.
- Understanding the prevalence and association of hyperhomocysteinemia with CHD in specific populations is crucial for public health.
Purpose:
- To determine the prevalence of hyperhomocysteinemia in Tunisian patients with angiographically proven coronary heart disease.
- To investigate the relationship between hyperhomocysteinemia and coronary heart disease in this population.
- To assess whether hyperhomocysteinemia is an independent risk factor for CHD, even after adjusting for other cardiovascular risk factors.
Summary:
- This study analyzed plasma homocysteine, folate, and vitamin B12 levels in 70 Tunisian coronary heart disease patients and 140 healthy controls.
- Hyperhomocysteinemia (homocysteine >17 micromol/L) was significantly more prevalent in patients (29%) compared to controls (10%).
- A significant independent association was found between hyperhomocysteinemia and coronary heart disease (adjusted OR, 2.99; p=0.02), suggesting a role in atherothrombogenesis, though causality is not yet established.
Impact:
- The findings highlight hyperhomocysteinemia as a significant, independent risk factor for coronary heart disease in the Tunisian population.
- This suggests that screening for and managing hyperhomocysteinemia may be beneficial in patients with coronary heart disease.
- Further research into homocysteine-lowering therapies is warranted to establish a causal relationship and guide clinical practice.
Abstract:
We have determined the prevalence of hyperhomocysteinemia and tested its relationship with coronary heart disease in Tunisian patients. The study included 70 angiogrphically proven coronary patients and 140 age- and sex-matched healthy subjects. Plasma homocysteine folate and vitamin B12 were analyzed by immunoenzymatic methods. Hyperhomocysteinemia was considered for plasma homocysteine concentration >17 micromol/L. Mean plasma homocysteine concentration and hyperhomocysteinemia prevalence were significantly (p<0.001) higher in patients (16.3 +/- 7.9 micromol/L and 29%) than controls (12.6 +/- 4.0 micromol/L and 10%). The association between hyperhomocysteinemia and coronary heart disease persisted after adjusting on main cardiovascular risk factors (multi adjusted odds ratio, 2.99; 95% CI, 1.18-7.59; p=0.02). No association was observed between hyperhomocysteinemia and coronary disease severity and extent. This study showed an independent association between hyperhomocysteinemia and coronary heart disease, suggesting a role of hyperhomocysteinemia in atherothrombogenesis. However, causal relationship is not yet established. Until results of homocysteine-lowering therapy trials become available, hyperhomocysteinemia should be researched and treated in coronary heart disease patients.
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