Plasma homocysteine level and the angiographic extent of coronary artery disease

Recent epidemiologic studies have shown that moderately elevated plasma homocysteine concentrations are associated with an increased risk for the development of atherosclerotic cardiovascular diseases. But, it is not known whether moderate hyperhomocysteinemia is associated with the angiographic extent of atherosclerotic cardiovascular disease in patients with coronary artery disease (CAD). A possible relationship was investigated between admission plasma homocysteine level and the angiographic extent of coronary artery disease in patients with CAD. In this study, 156 consecutive patients presenting with coronary artery disease (group 1) and control group (group 2) of 35 age-matched persons with normal coronary angiography were enrolled. Blood samples for homocysteine were obtained on admission. Plasma homocysteine concentration was measured with high-performance liquid chromatography with fluorescence detection. Radiographs from coronary angiography were viewed and scored using Sullivan's method to assess the atherosclerotic involvement of coronary artery disease. There were significant elevations in homocysteine level in group I compared to group 2 (15.59 +/- 5.7 mumol/L, 9.24 +/- 1.50 mumol/L; respectively, p < 0.001). All scores (demonstrated angiographic extension of CAD) correlated significantly with plasma homocysteine levels; however, the Sullivan's extent score correlated more closely (r = 0.68, p < 0.001) than both the stenosis score (r = 0.44, p < 0.01) and vessel score (r = 0.35, p < 0.05). Elevated homocysteine levels in patients with coronary artery disease correlated with the angiographic extent of atherosclerotic disease.