Title: Influence of homocysteine concentration on clinical course and angiographic presentation of ischemic heart disease
- Joanna Wilczyńska, Grzegorz J. Horszczaruk, Justyna Kotlicka, Janusz Kochman, Marzena Iwanowska, Dariusz Kosior, Dagna Bobilewicz, Grzegorz Opolski
- Original articles
- Polish Journal of Cardiology
- Start page:
- Final page:
- ischemic heart disease, homocysteine, coronary angiography, risk factors
Introduction: A growing attention is being paid upon new risk factors of ischemic heart disease (IHD). Homocysteine (Hcy) represents such newly established factor. Its elevated concentration causes endothelial dysfunction and promotes thrombosis. These processes may result in formation and progression of atheroslerotic lesions.
Aim: The analysis of clinical course of IHD and angiographic presentation of coronary arteries in patients with and without hyperhomocysteinaemia
Material and methods: 77 pts with diagnosed IHD, referred to coronary angiographywereenrolled. Plasma Hcy and folate concentration were measured. Clinical manifestation of IHD was noted. Extension of atheroscle-rosis (according to Gensini scalę) and number of arteries with significant stenosis (i.e. >50% vessel lumen) were assessed with coronary angiography.
Results: there were 48 (62%) men and 29 (38%) women in study group. Mean age 57±9.3 years. Indications for coronary angiography were: stable angina (SA) in 39% pts, unstable angina (UA) in 38% pts, reccurent myocardial infartion(MI)(10-20day) in 23% pts. Upper limit ofnormal Hcy- 12.99 u mol/L. In 45% ptselevated Hcyconcentration wasobserved. Mean Hcy concentration inSA-ptswas 11.63±2.65, in UA-ptswas 13.92±5.59 and in Ml-ptswas 14.79±4.2. Mean Hcyconcentration was significantly higher in Ml-ptsthan in SA-pts (p=0.002). In UA-pts mean Hcy concentration was higher than in SA-pts, with borderline positi-ve statistical trend (p=0.05). Elevated Hcywaspresent morę often in ptswith the mostsevere presentation of coronary atherosclerosis (>80 points in Gensini scalę) than in pts without detectable lesions in coronary angiography(83% vs. 31%, p<0.05).
Conclusions: Significantly higher Hcy concentration was present in pts with unstable angina and after acute myocardial infarction (10-20 day). Significantly higher Hcy concentration was present also in pts with the most extensive coronary atherosclerosis.