Homocysteine and Risk of Premature Coronary Heart Disease

Abstract

Background: Homocystinuria is a rare autosomal recessive disease complicated by early and aggressive occlusive arterial disease. This may be related to the grossly increased homocysteine concentrations seen in this disease. More recently, milder hyperhomocysteinemia has been proposed as an independent risk factor for coronary artery disease. Cardiovascular disease (CVD) is among the diseases with multiple contributing factors, hence making it difficult to pinpoint a particular factor alone. The main factor that is of relevance to this study is homocysteine. Coronary artery disease is the narrowing or blockage of the arteries and vessels that supply oxygen and nutrients to the heart (1, 2). CVD is the major cause of morbidity and mortality worldwide. Obesity, HTA, Diabetes mellitus, hypercholesterolemia, and smoking have been recognized as major risk factors for CVD.
 Aim: Aim of this paper is to examine concentrations of Hcyt and lipid profiles in patients with CVD and positive personal history for CVD, comparing them with the control group composed of healthy individuals. Our study aimed to verify the role of Homocysteine as a new independent risk factor on the onset of early atherosclerosis and atheromatous processes in coronary arteries in patients with CVD.
 Materials and methods: The results obtained represent the average value earned once every three months in the 3 year period. 5ccm serum with a few heparin spots was sent to the Clinical Laboratory of the University Clinic of Skopje.
 Results: The results obtained from patients with CVD and control groups are presented in the following text, where a statistically significant difference was observed for p <0.0001 between the parameters obtained by patients with CVD compared to the control group. Concentrations of homocysteine and lipids in patients with CVD compared to the control group showed statistically significant difference with p<0.0001, expected results, and verified in many other multicentric studies. These facts show that raised Hcyt has more impact on the onset of CVD. When Hcy levels are in the blood, the activity of the cystathionine-synthetase enzyme is raised. It is believed that this enzyme plays a vital role in the metabolism of Hcyt. In recent years a lot of studies have been made on the effect of hyperhomocysteinemia and its impact on the onset of coronary and all have verified that hyperhomocysteinemia is a significant parameter for the onset of early atherosclerosis of coronary and CVD(6,7,8).
 Conclusions: In the above-mentioned cases, it is recommended substitutive therapy with folic acid, pyridoxine, vitamin B12, vitamin E and other antioxidants which are found that have an effect on the prevention of premature atherosclerosis in patients with CVD and raised Hcyt: acute myocardial infarction, CARB, angina pectoris. PTCA, Stenting, and prevention of stroke.