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The Impact of Hyperhomocysteinemia as a Cardiovascular Risk Factor in the Prediction of Coronary Heart Disease

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Published/Copyright: June 1, 2005
Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Volume 41 Issue 11

Abstract

Coronary heart disease often occurs in the absence of traditional risk factors. Consequently, epidemiological studies exploring novel risk factors are necessary to improve the prediction of coronary heart disease. This study evaluated five promising markers of cardiovascular risk: homocysteine, C-reactive protein, fibrinogen, lipoprotein(a) (Lp(a)), free apolipoprotein(a) (apo(a)) and Lp(a) phenotypes. The study included 135 patients with angiographically confirmed atherosclerosis. The control group consisted of 93 sex- and age-matched individuals. The Mann-Whitney U-test was used for group comparison. New risk factors were evaluated by binary logistic regression. The odds ratios were calculated continuously for homocysteine in dependence on C-reactive protein. Low density lipoprotein (LDL)-cholesterol was nearly identical in controls and patients. Homocysteine, C-reactive protein, fibrinogen, high density lipoprotein (HDL)-cholesterol and Lp(a) discriminated highly significantly between both groups. The continuously calculated odds ratio for homocysteine demonstrated a distinct influence of C-reactive protein. In the group with high C-reactive protein levels, homocysteine levels above 9.6 μmol/l resulted in a markedly elevated risk (odds ratio 12), in the group with C-reactive protein levels below 5 mg/dl, a comparable risk increase was observed at a homocysteine level of 16.6 μmol/l. This data strongly suggests that plasma homocysteine helps identify individuals at risk, especially among those with elevated C-reactive protein levels.

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Published Online: 2005-06-01
Published in Print: 2003-11-17

Copyright © 2003 by Walter de Gruyter GmbH & Co. KG

Articles in the same Issue

  1. Where Are We Standing in Homocysteine Research?
  2. DACH-LIGA Homocystein (German, Austrian and Swiss Homocysteine Society): Consensus Paper on the Rational Clinical Use of Homocysteine, Folic Acid and B-Vitamins in Cardiovascular and Thrombotic Diseases: Guidelines and Recommendations
  3. Hyperhomocysteinaemia as a Risk Factor for Venous Thrombosis: An Update of the Current Evidence
  4. Does Homocysteine Cause Hypertension?
  5. Homocysteine Metabolism in Renal Disease
  6. Hyperhomocysteinemia and B-Vitamin Deficiencies in Infants and Children
  7. The Role of Genetic Factors in the Development of Hyperhomocysteinemia
  8. New Basis of the Neurotrophic Action of Vitamin B12
  9. Hyperhomocysteinemia and Immune Activation
  10. Interactions of Homocysteine, Nitric Oxide, Folate and Radicals in the Progressively Damaged Endothelium
  11. Influence of Hyperhomocysteinemia on the Cellular Redox State – Impact on Homocysteine-Induced Endothelial Dysfunction
  12. Homocysteine-Thiolactone and S-Nitroso-Homocysteine Mediate Incorporation of Homocysteine into Protein in Humans
  13. Association of Asymmetric Dimethylarginine and Endothelial Dysfunction
  14. Genetic Determinants of Folate and Vitamin B12 Metabolism: A Common Pathway in Neural Tube Defect and Down Syndrome?
  15. Functional Vitamin B12 Deficiency and Determination of Holotranscobalamin in Populations at Risk
  16. Holotranscobalamin as a Predictor of Vitamin B12 Status
  17. Hyperhomocysteinemia and B-Vitamin Status after Discontinuation of Oral Anticoagulation Therapy in Patients with a History of Venous Thromboembolism
  18. Measurement of Carotid Plaque and Effect of Vitamin Therapy for Total Homocysteine
  19. Folate Improves Endothelial Function in Patients with Coronary Heart Disease
  20. The Impact of Hyperhomocysteinemia as a Cardiovascular Risk Factor in the Prediction of Coronary Heart Disease
  21. Homocysteine Increases during Endurance Exercise
  22. Comparison of the Influence of Volume-Oriented Training and High-Intensity Interval Training on Serum Homocysteine and Its Cofactors in Young, Healthy Swimmers
  23. Analysis of the Transcobalamin II 776C>G (259P>R) Single Nucleotide Polymorphism by Denaturing HPLC in Healthy Elderly: Associations with Cobalamin, Homocysteine and Holo-Transcobalamin II
  24. Meetings and Awards
https://doi.org/10.1515/CCLM.2003.232

Articles in the same Issue

  1. Where Are We Standing in Homocysteine Research?
  2. DACH-LIGA Homocystein (German, Austrian and Swiss Homocysteine Society): Consensus Paper on the Rational Clinical Use of Homocysteine, Folic Acid and B-Vitamins in Cardiovascular and Thrombotic Diseases: Guidelines and Recommendations
  3. Hyperhomocysteinaemia as a Risk Factor for Venous Thrombosis: An Update of the Current Evidence
  4. Does Homocysteine Cause Hypertension?
  5. Homocysteine Metabolism in Renal Disease
  6. Hyperhomocysteinemia and B-Vitamin Deficiencies in Infants and Children
  7. The Role of Genetic Factors in the Development of Hyperhomocysteinemia
  8. New Basis of the Neurotrophic Action of Vitamin B12
  9. Hyperhomocysteinemia and Immune Activation
  10. Interactions of Homocysteine, Nitric Oxide, Folate and Radicals in the Progressively Damaged Endothelium
  11. Influence of Hyperhomocysteinemia on the Cellular Redox State – Impact on Homocysteine-Induced Endothelial Dysfunction
  12. Homocysteine-Thiolactone and S-Nitroso-Homocysteine Mediate Incorporation of Homocysteine into Protein in Humans
  13. Association of Asymmetric Dimethylarginine and Endothelial Dysfunction
  14. Genetic Determinants of Folate and Vitamin B12 Metabolism: A Common Pathway in Neural Tube Defect and Down Syndrome?
  15. Functional Vitamin B12 Deficiency and Determination of Holotranscobalamin in Populations at Risk
  16. Holotranscobalamin as a Predictor of Vitamin B12 Status
  17. Hyperhomocysteinemia and B-Vitamin Status after Discontinuation of Oral Anticoagulation Therapy in Patients with a History of Venous Thromboembolism
  18. Measurement of Carotid Plaque and Effect of Vitamin Therapy for Total Homocysteine
  19. Folate Improves Endothelial Function in Patients with Coronary Heart Disease
  20. The Impact of Hyperhomocysteinemia as a Cardiovascular Risk Factor in the Prediction of Coronary Heart Disease
  21. Homocysteine Increases during Endurance Exercise
  22. Comparison of the Influence of Volume-Oriented Training and High-Intensity Interval Training on Serum Homocysteine and Its Cofactors in Young, Healthy Swimmers
  23. Analysis of the Transcobalamin II 776C>G (259P>R) Single Nucleotide Polymorphism by Denaturing HPLC in Healthy Elderly: Associations with Cobalamin, Homocysteine and Holo-Transcobalamin II
  24. Meetings and Awards
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