Elevated plasma homocysteine levels are associated with increased risk of vascular disease and with a relationship between homocysteine values and disease severity. Several studies have shown that the high plasma level of homocysteine is an important predictor for risk of cardiovascular events. We analysed the relationship between homocysteine concentrations and other risk factors into CAD progression in patients of prior myocardial infarction.
Methods: We performed a study including 208 patients (100 men and 108 women) divided into two groups: 104 patients with prior myocardial infarction and 104 without coronary artery disease.
Results: The patients with prior myocardial infarction had higher mean values of plasma homocysteine than the controls (18.98 +/- 4.72 vs. 14.09 +/- 3.32 micromol/L, p < or = .001). Multivariate analysis after the adjustment for age, gender and cardiovascular risk factors has identified homocysteine over 15 micromol/L as significant and independent cardiovascular risk factors (odds ratio 2.05; 95% CI 1.56-2.54). The correspondent Receiver Operator Curve shape suggested a good reliability in diagnosis of coronary artery disease for homocysteine (under curve area = 0.671, p < or = 001).
Conclusion: Our results showed a positive correlation between plasma homocysteine levels and severity of coronary lesions (r = 0.765, p < .005). We suggest the use of homocysteine in clinical practice as marker of cardiovascular risk assessment.