Combined effect of hyperhomocysteinemia and smoking on the severity of coronary artery disease in young adults ≤ 35 years of age: a hospital-based observational study

Abstract

Background The prevalence of coronary artery disease (CAD) continues to increase among young Chinese adults. Current smoking has been recognized as a major risk factor for premature CAD, and hyperhomocysteinaemia (HHcy) has also been suggested to be associated with CAD progression. However, the combined effect of current smoking and HHcy on the severity of coronary artery stenosis in young adults is still uncertain. Methods We consecutively collected young patients (18–35 years of age), diagnosed with CAD and underwent coronary angiography (CAG) at Anzhen Hospital between January 2013 and May 2020. HHcy was defined as serum homocysteine (Hcy) level > 15 µmol/L. The severity of coronary artery stenosis was evaluated by Gensini Score. The co-effect of current smoking and HHcy on CAD severity as well as the relationship between plasma Hcy, pack-years of smoking and CAD severity were assessed by multivariate linear regression analysis. Results A total of 989 participants (mean age, 33 years; 96.2% male) fulfilling the criteria were enrolled in this study. Patients with both HHcy and current smoking accounted for 39.1% of all the subjects. Multivariate liner analysis indicated both serum Hcy levels (β 0.302; 95% CI 0.141–0.462; P < 0.001) and pack-years of smoking (β 0.523; 95% CI 0.265–0.781; P < 0.001) were independently associated with the severity of coronary artery stenosis after adjusting for other traditional confounders. In addition, serum Hcy levels were correlated with pack-years of smoking in young CAD patients (r = 0.116, P = 0.001). Moreover, combination of HHcy and current smoking was suggested to have higher risk for CAD severity (β 17.892; 95% CI 11.314–24.469; P < 0.001), compared with HHcy (β 7.471; 95% CI 0.009–14.934; P = 0.048) or current smoking (β 7.421; 95% CI 0.608–14.233; P = 0.033) alone. Conclusion Combination of HHcy and smoking is independently associated with the severity of CAD in young patients ≤ 35 years of age.

Homocysteine as a Cardiovascular Risk Factor

“…Os estudos analisados consistiram em 11 estudos transversais (Ijaz, et al, 2015, Karim, et al, 2015, Prajapati, et al, 2015, Islam, et al, 2016, Kaur, et al, 2016, Chaudhary, et al, 2017, Qin, et al, 2017, Li, et al, 2021, Sun, et al, 2021, 3 estudos de coorte (Pac-Kozuchowska, et al, 2018, Raffield, et al, 2018, Monasso, et al, 2021, 3 ensaios clínicos randomizados (Cerbone, et al, 2016, Fruzzetti, et al, 2016, Momeni1comma, et al, 2019 e 18 estudos caso-controle (Islam, et al, 2015, Jain, et al, 2015, Kouzehgaran, et al, 2015, Ramkaran, et al, 2015, Iqbal, et al, 2016, İşgüven, et al, 2016, Lai, et al, 2017, Rallidis, et al, 2017, Gupta, et al, 2018, Vishwajeet, et al, 2018, Nedelcu, et al, 2021, Rafi, et al, 2021. A maioria dos estudos encontrou uma associação positiva entre os níveis Os dados descritivos dos estudos coletados estão apresentados na Tabela I, de acordo com gênero, países, procedimentos intervencionais, achados observacionais e associação com homocisteína.…”

Aldehyde dehydrogenase 2 rs671 a/A Genotype is Associated with an Increased Risk of Early Onset Coronary Artery Stenosis

“… 45 Smokers have a higher risk of CAD severity. 46 A higher percentage of smokers was observed in patients with higher immature platelet fraction (IPF) values, smoking was an independent predictor of higher IPF values, and IPF was associated with cardiovascular disease. 47 And smoking is one of the predictors of CAS in Japanese men.…”

The relationship between hyperhomocysteinemia and total coronary artery occlusion: a cross-sectional study from Southwest China

“…BMI and homocysteine levels were noted to vary between individuals with CAD versus those without CAD [44]. In young individuals (≤35 years old), hyperhomocysteinemia and smoking are associated with CAD severity [45]. Nicotine and carbon monoxide in tobacco exacerbated the inflammatory response and damaged the vascular endothelium by decreasing the production of nitric oxide and prostacyclin [46].…”