Association of serum homocysteine levels with the severity and calcification of coronary atherosclerotic plaques detected by coronary CT angiography

Aim. In this study, we aim to evaluate the association of risk factors including homocysteine (Hcy) with the severity and burden of coronary atherosclerotic plaques detected by computed tomography angiography (CTA). Methods. Six hundred fifty-nine subjects who underwent CTA for the assessment of coronary artery disease (CAD) were studied. All the subjects enrolled had no clinical cardiovascular disease symptoms. Logistic regression showed apart from age, hypertension, smoking, triglyceride, low-density lipoprotein (LDL) cholesterol, and total bilirubin, Hcy was an independently risk factor of the severity of coronary disease. And Hcy was also found an independent predictor for the presence of calcified plaque. When the participants were divided into 4 groups according to serum Hcy quartiles (Q1-Q4 groups), both the percentage of patients with >50% stenosis and the percentage of patients with calcified plaque were higher in Q4 compared to other groups. The OR of Hcy (>15 mu mol/L) for >50% stenosis was 2.212 (95% CI=1.119 to 4.375, P=0.022) and the OR for Hcy (>15 mu mol/L) for calcification was 1.668 (95% CI=1.030 to 2.699, P=0.037) respectively. Conclusion. Our study shows Hcy is independently associated with both the severity and calcified plaque detected by CTA. Hcy may provide additional information about CAD in the subjects without clinical symptoms.