Related Experiment Videos
The diagnostic value of serum homocysteine concentration as a risk factor for coronary artery disease
1Institut für Klinische Chemie und Pathobiochemie, Otto-von-Guericke Universität Magdeburg, Germany. jutta.dierkes@medizin.uni-magdeburg.de
Insights
Hyperhomocysteinemia, an elevated homocysteine level, is a significant risk factor for coronary artery disease. This study shows homocysteine is as important as traditional risk factors in identifying patients at high risk.
Area of Science:
- Cardiovascular Medicine
- Clinical Chemistry
Background:
- Hyperhomocysteinemia is a common risk factor for coronary artery disease (CAD).
- The diagnostic value of homocysteine compared to other risk factors for CAD is not well-established.
Purpose of the Study:
- To compare the diagnostic value of homocysteine with traditional risk factors for coronary artery disease.
- To evaluate the utility of receiver-operator characteristic (ROC) analysis for homocysteine in identifying high-risk individuals.
Main Methods:
- Retrospective case-control study involving 191 CAD patients and 231 healthy controls.
- Assessment of lifestyle habits via questionnaire.
- Measurement of laboratory parameters including homocysteine, folate, vitamin B12, lipoproteins, and lipids.
- Comparison of diagnostic values using ROC analysis.
Main Results:
- Homocysteine demonstrated significant discrimination between CAD cases and controls.
- ROC analysis indicated homocysteine is at least as important as conventional risk factors like high-density-lipoprotein cholesterol, triglycerides, and non-esterified fatty acids.
- Homocysteine showed weak correlations with folate, vitamin B12, age, and serum creatinine.
Conclusions:
- Hyperhomocysteinemia is a crucial risk factor for coronary artery disease, comparable in importance to established factors.
- ROC analysis of homocysteine is effective for identifying individuals at highest risk for CAD.
- Further clinical trials are warranted to investigate homocysteine-lowering therapies, such as vitamin supplementation, for CAD prevention.
Abstract:
Hyperhomocysteinemia is now regarded as an established risk factor for coronary artery disease and is present frequently in the general population. However, the diagnostic value of this risk factor relative to others has only occasionally been investigated. We compared the diagnostic value of classic risk factors and of homocysteine in a retrospective case-control study in 191 cases with angiographically established coronary artery disease and 231 healthy controls. Life style habits were assessed by a detailed questionnaire. Laboratory parameters including lipoproteins and blood lipids, homocysteine, folate, and vitamin B12 were measured and their diagnostic value compared with each other by use of receiver-operator characteristic analysis. Comparison of the receiver-operator characteristic curves revealed that homocysteine significantly discriminated between cases and control subjects. High-density-lipoprotein cholesterol, triglycerides and non-esterified fatty acids also had an area under the curve significantly different from 0.5 (the area under the curve representing no discrimination). Homocysteine was weakly related to folate, vitamin B12, age and serum creatinine concentration. We conclude that hyperhomocysteinemia is at least as important as conventional risk factors for coronary artery disease and that receiver operator characteristic analysis of homocysteine is suitable to determine patients at the highest risk for coronary artery disease. Clinical trials testing the effect of homocysteine lowering by vitamin supplementation in the prevention of coronary artery disease are needed.