Hyperhomocysteinemia as a metabolic disorder parameter is independently associated with the severity of coronary heart disease

Liu, Chenggui; Yang, Yingkui; Peng, Duanliang; Li-nong, Chen; Luo, Jun

doi:10.15537/smj.2015.7.11453

Cited by 13 publications

(9 citation statements)

References 40 publications

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“…[ 20 , 21 ] A recently published study from China that included 292 CAD patients of different categories, and 100 non-CAD controls concluded that HHcy is independently associated with the severity of CHD, and significantly correlated with low folic acid levels in CAD patients. [ 10 ] The above findings suggest a possible association between T genotype of MTHFR C677T gene, higher circulating Hcy, lower FA levels, and more severe coronary lesions. These results warrant interventions aimed at lowering of Hcy levels in high-risk patients, particularly in those with T genotype of MTHFR C677T gene.…”

Section: Discussionmentioning

confidence: 94%

“…[ 8 ] A recent randomized controlled trial in China demonstrated that additional administration of folic acid, an intervention for lowering circulating Hcy level, to hypertensive patients on enalapril significantly reduced the risk of first stroke in patients. [ 9 ] Although pilot studies have suggested that HHcy may be a risk factor for CAD, [ 10 ] the association between homocysteine and the severity of coronary lesions, particularly in patients with ACS, has rarely been reported.…”

Section: Introductionmentioning

confidence: 99%

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MTHFR C677T gene polymorphism and the severity of coronary lesions in acute coronary syndrome

Wang²,

Zhang³

et al. 2017

Medicine

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The association between methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism, circulating levels of homocysteine (Hcy), and the severity of coronary lesion in patients with acute coronary syndrome (ACS) remains unknown.Consecutive ACS patients were included. MTHFR C677T polymorphisms were determined via amplification refractory mutation system-polymerase chain reaction (ARMS-PCR). Gensini scores were used to evaluate the severity of coronary lesions.Three hundred ten ACS patients were included, and grouped according to the MTHFR C677T polymorphism variant: CC (n = 78, 25.2%), CT (n = 137, 44.2%), and TT (n = 95, 30.6%) groups. No significant differences were detected with respect to baseline characteristics. Patients in TT group had significantly higher Hcy, and significantly lower folic acid (FA) levels as compared with those in the other 2 groups (P < .05 for both). More importantly, patients with TT had more severe coronary lesions as compared with those from the other 2 groups, as evidenced by higher Gensini scores (P < .05 for both); however, no significant differences were observed with respect to the numbers of affected coronary arteries, or the number, length, and diameter of stents implanted in each group (P > .05 for all). On multivariate logistic regression analysis, presence of a T allele in MTHFR C677T was found to be independently associated with higher circulating Hcy (odds ratio [OR] = 1.06, 95% confidence interval [CI]: 1.01–1.12, P = .024), and higher Gensini scores (OR: 1.01, 95% CI: 1.00–1.02, P = .046).MTHFR C677T TT polymorphism was associated with higher Hcy levels and more severe coronary lesions in patients with ACS.

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Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

MTHFR C677T gene polymorphism and the severity of coronary lesions in acute coronary syndrome

Wang²,

Zhang³

et al. 2017

Medicine

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“…Folate and VB12 are two vital regulators of the metabolism of Hcy [43]. A significant association is observed between maternal lower folate concentrations and higher Hcy levels as well as an increase in the risk of preeclampsia [44].…”

Section: Discussionmentioning

confidence: 99%

Serum homocysteine and folate concentrations in early pregnancy and subsequent events of adverse pregnancy outcome: the Sichuan Homocysteine study

Liu

Luo

Wang

et al. 2020

BMC Pregnancy Childbirth

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Background: Hyperhomocysteinemia may be a risk factor for endothelial dysfunction. Folate and vitamin B12 regulate the homocysteine metabolic process. This study aimed to evaluate the associations between subsequent events of adverse pregnancy outcome and early variables of homocysteine, folate, and vitamin B12 in pregnant women. Methods: This multicenter, retrospective, case-control study involved 563 pregnant women with adverse pregnancy outcome and 600 controls. Adverse pregnancy outcomes included one or more of the following events: preeclampsia, preterm birth, low birth weight, and stillbirth. The associations between subsequent events of adverse pregnancy outcome and early variables of homocysteine, folate, and vitamin B12; metabolic parameters; inflammatory markers; anthropometrics; and lifestyle habits at 11-12 weeks of gestation were analyzed using the logistic regression model. Results: Compared to the lower quartile homocysteine concentrations, the upper quartile homocysteine concentrations were associated with preeclampsia, preterm birth and low birth weight. On the contrary, the lower quartile folate concentrations were associated with preeclampsia, preterm birth and low birth weight compared with the upper quartile folate concentrations. The incidence of adverse pregnancy outcome increased progressively from the first to fourth homocysteine quartiles but decreased progressively from the first to fourth folate quartiles. After adjusting for confounding factors, multivariate logistic regression analysis showed that besides systolic blood pressure, diastolic blood pressure, body mass index and age, homocysteine (IV vs I quartile, aOR 5.89, 95% CI 4.08-8.51, P < 0.001), folate (IV vs I quartile, aOR 0.35, 95% CI 0.25-0.50, P < 0.001), folate supplementation (yes vs no, aOR 0.55, 95% CI 0.35-0.86, P = 0.010) during early pregnancy were independently associated with subsequent events of adverse pregnancy outcome, and vitamin B12 was rejected. Of these, the homocysteine revealed the highest odds ratio in all risk variables, and folate showed the lowest odds ratio in all protective variables.

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“…Akyurek et al disclosed a higher serum homocysteine level in a STEMI group than in a healthy control group (19.0 ± 3.6 vs. 15.8 ± 4.2 μmol/L, p = 0.008) [ 10 ]. Liu C et al found that the prevalence of hyperhomocysteinemia (> 15 μmol/L) was higher among patients with ischemic heart disease than among controls (79.1% vs. 5%) [ 29 ], and the serum homocysteine level was positively correlated with severity (acute myocardial infarction 23.44 ± 5.78 μmol/L, unstable angina 22.62 ± 6.37 μmol/L, stable angina 18.63 ± 6.73 μmol/L, and control 10.81 ± 4.62 μmol/L, p < 0.001) [ 30 ]. In contrast, our study showed that there was no difference in serum homocysteine levels between the control and STEMI groups, and our cohort had a mean level of homocysteine markedly lower than the levels reported in previous studies.…”

Section: Discussionmentioning

confidence: 99%

Homocysteine is a bystander for ST-segment elevation myocardial infarction: a case-control study

Chen

Yang

Chang³

et al. 2018

BMC Cardiovasc Disord

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BackgroundHomocysteine has been long considered a risk factor for atherosclerosis. However, cardiovascular events cannot be reduced through homocysteine lowering by B vitamin supplements. Although several association studies have reported an elevation of serum homocysteine levels in cardiovascular diseases, the relationship of homocysteine with ST-segment elevation myocardial infarction (STEMI) is not well established.MethodsWe prospectively enrolled STEMI patients who were consecutively admitted to an intensive care unit following coronary intervention in a single medical center in Taiwan. Control subjects were individuals who presented to the outpatient or emergency department with acute chest pain but subsequently revealed patent coronary arteries by coronary arteriography. The association between serum homocysteine levels and STEMI was investigated. A culture system using human coronary artery endothelial cells was also established to examine the toxic effects of homocysteine at the cellular level.ResultsPatients with chest pain were divided into two groups. The STEMI group included 56 patients who underwent a primary percutaneous coronary intervention. The control group included 17 subjects with patent coronary arteries. There was no difference in serum homocysteine levels (8.4 ± 2.2 vs. 7.6 ± 1.9 μmol/L, p = 0.142). When stratifying STEMI patients by the Killip classification into higher (Killip III-IV) and lower (Killip I-II) grades, CRP (3.3 ± 4.1 vs. 1.4 ± 2.3 mg/L, p = 0.032), peak creatine kinase (3796 ± 2163 vs. 2305 ± 1822 IU/L, p = 0.023), and SYNTAX scores (20.4 ± 11.1 vs. 14.8 ± 7.6, p = 0.033) were significantly higher in the higher grades, while serum homocysteine levels were similar. Homocysteine was not correlated with WBCs, CRP, or the SYNTAX score in STEMI patients. In a culture system, homocysteine at even a supraphysiological level of 100 μmol/L did not reduce the cell viability of human coronary artery endothelial cells.ConclusionsHomocysteine was not elevated in STEMI patients regardless of Killip severity, suggesting that homocysteine is a bystander instead of a causative factor of STEMI. Our study therefore supports the current notion that homocysteine-lowering strategies are not essential in preventing cardiovascular disease.

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Hyperhomocysteinemia as a metabolic disorder parameter is independently associated with the severity of coronary heart disease

Cited by 13 publications

References 40 publications

MTHFR C677T gene polymorphism and the severity of coronary lesions in acute coronary syndrome

MTHFR C677T gene polymorphism and the severity of coronary lesions in acute coronary syndrome

Serum homocysteine and folate concentrations in early pregnancy and subsequent events of adverse pregnancy outcome: the Sichuan Homocysteine study

Homocysteine is a bystander for ST-segment elevation myocardial infarction: a case-control study

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