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The development of atherosclerotic changes and thromboembolism are common features in homocystinurics. Hence, we postulate a positive correlation between the level of homocyst(e)ine in the blood and the occurrence of coronary artery disease. Homocysteine is found either as free homocystine, cysteine-homocysteine mixed disulfide, or protein-bound homocyst(e)ine. In nonhomocystinuric subjects, most homocysteine molecules are detectable in the protein-bound form. Thus, protein-bound homocyst(e)ine in stored plasma which reflected total plasma homocyst(e)ine was determined in 241 patients with coronary artery disease (173 males and 68 females). The mean±SD total plasma homocyst(e)ine was 5.41±1.62 nmol/ml in male patients, 437±1.09 nmol/ml in male controls, 5.66±1.93 nmol/ml in female patients, and 4.16±1.62 nmol/ml in female controls. The differences between the patients with coronary artery disease and the controls were statistically significant (P < 0.0005).

Adding laboratory data (often available electronically) to restricted administrative data sets can provide accurate predictions of inpatient death from acute myocardial infarction, cerebrovascular accident, congestive heart failure, or pneumonia. This alternative avoids the cost of data abstraction and the serious errors associated with using administrative data alone.

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