Clinical Correlation between Plasma Homocysteine Level and Coronary Artery Disease in Indian Patients

Ranjith, R; P, Devika

doi:10.4236/wjcd.2017.712047

Cited by 7 publications

(4 citation statements)

References 20 publications

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“…There was no increased risk observed because of the presence of Homocysteine and other risk factors combination. Similar results were obtained by recent studies [19]. But some other studies showed positive association [20].…”

Section: Discussionsupporting

confidence: 91%

Study of Risk Factors of Coronary Artery Disease with Special Reference to Homocysteine

Sreenija¹,

Sambu²,

Kedam³

et al. 2019

SIJB

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Background: Risk factor reduction is the primary clinical approach in preventing coronary artery disease. Traditional risk factors are found to be absent in many of the cases. Novel risk factorhyper homocysteinemia was reported to be associated with the disease process. Objectives: This study is aimed at identifying the association of coronary artery disease with homocysteine and other conventional risk factors, along with the risk they pose both independently and in combination. Methods: The study included 100 people, 60 subjects in the study group with diagnosed coronary artery disease & 40 subjects in the control group with no disease. Conventional risk factors are evaluated & compared along with homocysteine levels. Results: The data obtained concludes that the levels of homocysteine independently are significantly higher (20.19 ± 5.00) among the study than the control group (12.35 ± 3.39).However, there was no significant association between conventional risk factors homocysteine levels and conventional risk factors (smoking, family history of coronary artery disease, hypertension and diabetes). Conclusion: Elevated levels of homocysteine are associated with coronary artery disease. Homocysteine, in combination with the conventional risk factors, did not pose any increased risk for the disease. Raised levels of Homocysteine in the controls is probably attributed to the early sign of disease occurrence, further investigation is required into this aspect. Also, an investigation is necessary to search for the ways of reduction of risk like vitamin supplementation.

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Section: Discussionsupporting

confidence: 91%

Study of Risk Factors of Coronary Artery Disease with Special Reference to Homocysteine

Sreenija¹,

Sambu²,

Kedam³

et al. 2019

SIJB

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“…Ranjith and all, in a study of 150 subjects, confirmed that increased homocysteine levels are independent risk factor for CAD, though no correlation with other risk factors was found [11].…”

Section: Discussionmentioning

confidence: 93%

Plasma Homocysteine in Patients with Coronary and Carotid Artery Disease: A Case Control Study

Bosevski

Zlatanovikj²,

Petkoska

et al. 2020

Prilozi

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AbstractIntroduction: Homocystein (Hcy) is an amino acid and elevated plasma cause endothelial damage, followed with inflammation in the blood vessels and its progression in atherosclerosis. We aimed to evaluate the correlation between cardiovascular disease and serum homocysteine levels..Methods: We performed a case control analysis of 212 patients, either for cardiovascular risk stratification or for invasive diagnostics and treatment of cardiovascular ischemic disease (CAD). Patients were divided into 4 groups: Group 1. Patients with low risk for CAD, with no symptoms of CAD and total of 10 years risk <10%. Group 2. High-risk patients with no symptoms of CAD, but 10 years total CAD risk of >20%. Group 3. Patients with symptomatic CAD, where angiography was performed and >50% occlusion of at least one coronary vessel was found. Group 4. Patients with carotid artery disease and documented CAD.Results: Group 1 consists of 56 subjects, of whom 33 (60%) males and 22 (40%) females. Their mean age was 52.18±8.07 years and their average CAD risk was 5.Group 2 included 60 patients, with average CAD risk of 23.73. There was a statistically significant difference between plasma homocysteine levels between the control and high CAD risk group, as well as between those with CAD and both CAD and CARD (p=0.001). In the high-risk subjects group, the level of homocysteine correlates albeit weak with the total CAD risk (p=0.04). Homocysteine levels correlate with the WBC count (p=0.02). In the subgroup of smokers with high CAD risk, homocysteine correlates with age, total CAD risk, total cholesterol, BUN (define BUN) and creatinine.Group 3 consisted of 49 subjects with manifested and angiographically proven CAD, out of whom 80% were males and 20% females, mean age 56.06±9.7 years, with average 2 coronary vessels affected. There were significantly higher homocysteine plasma levels between the control group and the group with manifested CAD (p=0.008).There is no significant difference of homocysteine plasma levels between the high risk group and the group with manifested coronary artery disease (15.03□mol/l vs. 16.38□mol/l). In this group, plasma levels of homocysteine correlate only with the highest level of vessel stenosis (>95%) with (p=0.04).The study population in group 4 showed a mean of IMT 0.9 +..09 mm and mean Hcy plasma levels of 21 + 11 µmol/L. From the evaluated patients with CAD, 82.9% of patients had elevated level of Hcy. From those, one showed elevated Hcy, 79.4 % had hypertension, 58.9 % had hyperlipidemia, 28.2% had diabetes mellitus as additional risk factors for atherosclerosis. 76.9 % of the patients had increased intima-media thickness; in 58.9 % plaques were detected, while 23 % of the patients had significant stenosis: 10.2 % with intermediate–grade stenosis (50-69%) and 12.8 % with high-grade stenosis (70-99 %). 17.1 % of the patients had normal level of Hcy, and in those ones 62.5 % only had increased IMT. We found linear correlation between IMT and HCy levels (r 0.7, p 0.05).Case control analysis showed significant higher level of Hcy in the group with CAD and carotid artery disease vs. CAD group (p 0.001).Conclusion:High plasma homocysteine concentrations are associated with high risk for vascular disease and consequently CAD itself and carotid artery disease, as well, proving its likely role in the development of atherosclerosis on inflammatory and metabolic levels.

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“…The role of homocysteine, which is a sulphur containing amino acid derived from the metabolism of essential amino acid methionine, has been emerged as a newly recognized risk factor (Ranjith and Devika, 2017). The raised plasma homocysteine level above 15 micromoles per liter (mcmol/L) is called hyperhomocysteinemia which promotes thrombosis and acts as a contributory factor for the adverse coronary events (Ranjith and Devika, 2017). Many studies have been conducted on the role of homocysteine (Hcy) as an independent risk factor for CHD.…”

Section: Introductionmentioning

confidence: 99%

Hyperhomocysteinemia as an Independent Risk Factor for Coronary Heart Disease. Comparison with Conventional Risk Factors

et al. 2023

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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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Clinical Correlation between Plasma Homocysteine Level and Coronary Artery Disease in Indian Patients

Cited by 7 publications

References 20 publications

Study of Risk Factors of Coronary Artery Disease with Special Reference to Homocysteine

Study of Risk Factors of Coronary Artery Disease with Special Reference to Homocysteine

Plasma Homocysteine in Patients with Coronary and Carotid Artery Disease: A Case Control Study

Hyperhomocysteinemia as an Independent Risk Factor for Coronary Heart Disease. Comparison with Conventional Risk Factors

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