Role of plasma homocysteine levels and other associated factors with coronary artery disease among Palestinian patients in North Palestine: a case control study

Abstract

Introduction coronary artery disease (CAD) is one of the leading causes of death worldwide, only two thirds of cases can be explained by CAD´s classical risk factors. There is an increase in attention to homocysteine as a causal of CAD. In Palestine, CAD is more common than that in regional surrounding areas. Coronary artery disease is considered the leading cause of death in the West Bank, according to Palestinian Ministry of health annual reports. The study was conducted to determine the level of homocysteine in individuals with no history of CAD and to determine the relationship between CAD and total homocysteine levels and classical risk factors of CAD. Methods our study is a hospital-based case-control study. A sample size of 84 cases and 81 controls were included in the study. Results there is a statistically significant increase in plasma total homocysteine level in cases compared to controls (P=0.04) with Odds ratio= 2. There is also a statistically significant association between plasma total homocysteine levels and age of 50 years and above and male gender among both study groups (P= 0.002 and 0.007, respectively). The study showed no significant association between plasma total homocysteine level and the CAD´s classical risk factors among the case group measured in the study, which are diabetes mellitus, hypertension, and smoking (P=0.5, 0.1, and 0.5, respectively). Conclusion there is a significant difference in homocysteine levels between case and control groups. Coronary artery disease patients have double homocysteine levels compared to those healthy individuals with OR= 2. Healthy Palestinian individuals have a homocysteine level that is lower than that of regional communities. Homocysteine levels increase with advanced age and male gender. There is no significant relation between hyperhomocysteinemia and diabetes mellitus, hypertension, and smoking.

Hypertension and cystatin C account for sex differences in serum homocysteine levels in acute coronary syndrome subjects with normal serum creatinine

“…The study by Chou and colleagues demonstrated that male subjects had higher homocysteine levels than female participants and the mean levels of plasma homocysteine were significantly higher in occluded coronary artery disease or in maintenance hemodialysis than in age-matched normal subjects [ 17 ]. Moreover, fasting plasma homocysteine levels were significantly elevated in adult men compared to women among coronary artery disease subjects including ACS patients [ 5 , 18 ]. In the present study, we found that the gender-associated difference also existed in ACS patients with normal renal function, with higher plasma concentration of homocysteine in adult men.…”