Correlation of hyper-homocysteinemia with coronary artery disease in absence of conventional risk factors among young adults

Shah, Hammad; Jan, Muneeb Ullah; Altaf, Afrasyab; Salahudin, Momin

doi:10.1016/j.jsha.2018.04.002

Cited by 23 publications

(14 citation statements)

References 23 publications

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“…Additionally, the results of a few available studies were conflicting. A case–control study carried out among patients aged < 40 years showed a positive correlation between HHCY and CAD occurrence [ 21 ]. In comparison, another study showed no difference of serum HCY level between healthy controls and young AMI patients aged ≤ 35 years [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Associations between hyperhomocysteinemia and the presence and severity of acute coronary syndrome in young adults ≤ 35 years of age

Sun

Han

et al. 2021

BMC Cardiovasc Disord

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Background The prevalence of acute coronary syndrome (ACS) continues to increase among young Chinese adults. Homocysteine (HCY) has been suggested as a promoter of atherosclerosis leading to coronary artery disease (CAD). Yet, it remains uncertain whether HCY is associated with the ACS and the severity of coronary artery stenosis in young adults. Methods Young patients (18–35 years of age) diagnosed with ACS who underwent coronary angiography (CAG) at Anzhen Hospital between January 2013 and June 2019 were assigned to the ACS group. As confirmed by CAG during the same period, an equivalent age-matched population without CAD was assigned to the non-CAD group. A serum HCY level > 15 µmol/L was defined as hyperhomocysteinemia (HHCY). The Gensini score assessed the severity of coronary artery stenosis. Results A total of 1103 participants, including 828 ACS patients and 275 non-CAD subjects, were enrolled in this study. Young ACS patients had higher level of serum HCY and greater prevalence of HHCY compared with non-CAD subjects [for HCY, 16.55 (11.93–29.68) vs 12.50 (9.71–17.42), P < 0.001; for HHCY prevalence, 62.08% vs 26.18%, P < 0.001]. Multivariate logistic regression analysis with the stepwise method indicated that HHCY was an independent predictor associated with the presence of ACS, after adjusting for traditional confounders (OR, 4.561; 95% CI, 3.288–6.327; P < 0.001). Moreover, young ACS patients with HHCY had increased prevalence of ST-segment elevation myocardial infarction (STEMI) (P = 0.041), multi-vessel disease (P = 0.036), and decreased value of left ventricular ejection fraction (LVEF) (P = 0.01). Also, the HCY level was significantly correlated with Gensini Score in ACS patients (r = 0.142, P < 0.001). Conclusion HHCY is significantly associated with the presence of ACS and the severity of coronary artery stenosis in young adults ≤ 35 years of age.

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Section: Discussionmentioning

confidence: 99%

Associations between hyperhomocysteinemia and the presence and severity of acute coronary syndrome in young adults ≤ 35 years of age

Sun

Han

et al. 2021

BMC Cardiovasc Disord

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“…Specific targets to increase the availability of methyl donor include acceleration of the conversion from homocysteine to methionine. Abnormally high levels of homocysteine have been reported to be a significant risk factor for the development of a wide range of diseases such as in cerebrovascular diseases [ 241 , 242 , 243 , 244 ], various CVDs [ 245 , 246 , 247 , 248 , 249 ], cognitive impairment including Alzheimer’s disease [ 250 , 251 , 252 ], fractures [ 253 , 254 , 255 ], and mortality [ 256 ]. Deficiencies of vitamin B12, folate, or vitamin B6 seem to play an important role in the occurrence of hyperhomocysteinemia, because they are essential for homocysteine metabolism ( Figure 2 ), and treatment with B-vitamin supplementation (B6, B12, and folate) has been demonstrated to effectively lower homocysteine levels [ 257 , 258 , 259 , 260 , 261 ].…”

Section: Nutrients and Their Metabolites And Enzymes Related To Dnmentioning

confidence: 99%

Polyamine Metabolism and Gene Methylation in Conjunction with One-Carbon Metabolism

Soda

2018

IJMS

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Recent investigations have revealed that changes in DNA methylation status play an important role in aging-associated pathologies and lifespan. The methylation of DNA is regulated by DNA methyltransferases (DNMT1, DNMT3a, and DNMT3b) in the presence of S-adenosylmethionine (SAM), which serves as a methyl group donor. Increased availability of SAM enhances DNMT activity, while its metabolites, S-adenosyl-l-homocysteine (SAH) and decarboxylated S-adenosylmethionine (dcSAM), act to inhibit DNMT activity. SAH, which is converted from SAM by adding a methyl group to cytosine residues in DNA, is an intermediate precursor of homocysteine. dcSAM, converted from SAM by the enzymatic activity of adenosylmethionine decarboxylase, provides an aminopropyl group to synthesize the polyamines spermine and spermidine. Increased homocysteine levels are a significant risk factor for the development of a wide range of conditions, including cardiovascular diseases. However, successful homocysteine-lowering treatment by vitamins (B6, B12, and folate) failed to improve these conditions. Long-term increased polyamine intake elevated blood spermine levels and inhibited aging-associated pathologies in mice and humans. Spermine reversed changes (increased dcSAM, decreased DNMT activity, aberrant DNA methylation, and proinflammatory status) induced by the inhibition of ornithine decarboxylase. The relation between polyamine metabolism, one-carbon metabolism, DNA methylation, and the biological mechanism of spermine-induced lifespan extension is discussed.

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“…Similar comparable findings were observed in Pakistani subjects where 63.2% were from rural area and 36.8% from urban. Prevalence of hyperhomocystenemia was documented as higher in northern population and male patients,15 and hyperhomocystenemia has positive correlation with coronary artery disease 16. Moreover, majority of our population lives in rural area 17.…”

Section: Discussionmentioning

confidence: 70%

Gender based differences in clinical and Angiographic characteristics and outcomes of Acute Coronary Syndrome (ACS) in Asian population

Altaf

Shah²,

Salahuddin³

2019

Pak J Med Sci

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Objective: There is very limited data about gender based differences in Acute Coronary Syndrome (ACS) in Asian population. This study was therefore aimed to ascertain gender based differences in clinical and angiographic characteristics and clinical outcomes in patient admitted with ACS. Methods: This was a cross sectional, observational study including patients admitted with diagnosis of ACS. Patients were divided into two groups (Males and Females) and their clinical characteristics were noted. Gender based assessment was done following coronary angiography. Results: A total of 386 patients were included, with 210 males and 176 females. Anterior wall myocardial infarction (AWMI) was present in 177(45.86%) patients. Mean age was 72.8±12.9 years in females and 66.8±11.2 years in males. Diabetes was present in 38.1% females and 31% males. Patients from rural population were 225(58.3%), while from urban 161(41.7%). Mean ejection fraction was 43.9±7.9% in women and 38.2±8.68% in males. Conclusion: ACS was more common in males, rural population and AWMI was most common cause. Women were more elderly and had more adverse events as compared to males. Impaired renal dynamics were more commonly observed in males. Women were less aggressively treated with coronary interventions and radial approach was better tolerated regardless of gender. doi: https://doi.org/10.12669/pjms.35.5.743 How to cite this:Altaf A, Shah H, Salahuddin M. Gender based differences in clinical and Angiographic characteristics and outcomes of Acute Coronary Syndrome (ACS) in Asian population. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.743 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Correlation of hyper-homocysteinemia with coronary artery disease in absence of conventional risk factors among young adults

Abstract: Hyper-homocysteinemia has positive correlation with coronary artery disease among young adults in the absence of conventional risk factors.

Cited by 23 publications

References 23 publications

Associations between hyperhomocysteinemia and the presence and severity of acute coronary syndrome in young adults ≤ 35 years of age

Associations between hyperhomocysteinemia and the presence and severity of acute coronary syndrome in young adults ≤ 35 years of age

Polyamine Metabolism and Gene Methylation in Conjunction with One-Carbon Metabolism

Gender based differences in clinical and Angiographic characteristics and outcomes of Acute Coronary Syndrome (ACS) in Asian population

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