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Hyperhomocysteinemia as an Independent Risk Factor for Coronary Heart Disease. Comparison with Conventional Risk
R Muzaffar1, M A Khan2, M H Mushtaq3
1Rashid Latif Medical College, Department of Nutritional Sciences, Lahore, Pakistan.
Insights
Elevated plasma homocysteine is a significant independent risk factor for coronary heart disease (CHD). This finding suggests homocysteine levels can predict future cardiovascular disease (CVD) risk, even beyond traditional factors.
Area of Science:
- Cardiovascular Medicine
- Biochemistry
- Epidemiology
Background:
- Coronary heart disease (CHD) remains a leading cause of mortality worldwide.
- Identifying novel risk factors independent of conventional ones is crucial for effective prevention strategies.
- Elevated plasma homocysteine has been investigated as a potential contributor to cardiovascular disease (CVD).
Purpose of the Study:
- To evaluate the association between raised plasma homocysteine concentrations and coronary heart disease (CHD).
- To determine if plasma homocysteine is an independent risk factor for CHD, irrespective of traditional risk factors.
- To assess the predictive value of plasma homocysteine for future cardiovascular events.
Main Methods:
- A case-control study involving 210 subjects (105 CHD cases, 105 healthy controls) aged 25-60 years.
- Plasma homocysteine levels were measured using fluorescence polarization immunoassay (FPIA).
- Conventional risk factors (age, sex, family history, hypertension, smoking, physical activity) were assessed and compared between groups.
Main Results:
- Mean plasma homocysteine levels were significantly higher in CHD cases (22.33±9.22 µmol/L) compared to controls (12.59±3.73 µmol/L) (p<0.001).
- Logistic regression analysis revealed a strong association between hyperhomocysteinemia and CHD (OR 7.45), which persisted in multivariate analysis (OR 7.10).
- Elevated homocysteine was confirmed as an independent risk factor for CHD, independent of conventional risk factors.
Conclusions:
- Elevated plasma homocysteine is a significant and independent risk factor for coronary heart disease.
- Plasma homocysteine levels can serve as a valuable biomarker for predicting the future risk of cardiovascular disease (CVD).
- This finding supports the potential role of homocysteine-lowering strategies in CHD prevention.
Abstract:
The present study was designed to evaluate the strength of association of raised plasma homocysteine concentration as a risk factor for coronary heart disease independent of conventional risk factor. It was a case control study conducted at Punjab Institute of Cardiology Lahore. A total of 210 subjects aged 25 to 60 years comprising of 105 newly admitted patients of CHD as cases and 105 age and sex matched healthy individuals with no history of CHD as control were recruited for the study. Fasting blood samples were obtained from cases and controls. Plasma homocysteine was analyzed by fluorescence polarization immunoassay (FPIA) method on automated immunoassay analyzer (Abbott IMX). Total cholesterol, triglyceride and HDL cholesterol were analyzed using calorimetric kit methods. The concentration of LDL cholesterol was calculated using Friedewald formula. The patients were also assessed for traditional risk factors such as age, sex, family history of CVD, hypertension, smoking and physical activity, and were compared with control subjects. The collected data was entered in SPSS version 24 for analysis and interpretation.The mean age in controls and experimental groups were 43.00± 8.42 years and 44.72± 8.59 years with statistically same distribution (p- value= 0.144). The mean plasma homocysteine for cases was 22.33± 9.22 µmol/L where as it was 12.59±3.73 µmol/L in control group. Highly significant difference was seen between the mean plasma level of homocysteine in cases and controls (p˂0.001).Simple logistic regression indicates a strong association of coronary heart disease with hyperhomocysteinemia (OR 7.45), which remained significantly associated with coronary heart disease by multivariate logistic regression (OR 7.10, 95%C1 3.12-12.83, p=0.000). The present study concludes that elevated levels of Plasma homocysteine is an independent risk factor for coronary heart disease independent of conventional risk factors and can be used as an indicator for predicting the future possibility for the onset of CVD.
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