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Hyperhomocysteinemia is an independent risk factor in young patients with coronary artery disease in southern China

Hyperhomozysteinämie ist ein unabhängiger Risikofaktor bei jungen Patienten mit koronarer Herzkrankheit in Südchina

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Abstract

Background

Elevated plasma homocysteine (Hcy) is considered to be a risk factor of coronary artery disease (CAD), although this is still controversially discussed. This study investigated the role of Hcy in young patients with CAD in southern China.

Methods

A total of 146 consecutive patients (aged ≤ 55 years) with angiographically proven CAD were enrolled in the study and 138 age-matched non-CAD individuals were included as the control group. Hcy levels were measured by enzymatic assay. Hyperhomocysteinemia (HHcy) was defined as Hcy ≥ 15 µmol/l. A 10-year CAD risk was calculated using the Framingham risk score (FRS) modified according to the National Cholesterol Education Program Adult Treatment Panel III.

Results

There were significant differences between the CAD and control groups with regard to male sex (P < 0.01), smoking history (P < 0.05), and triglyceride levels (TG, P < 0.05), but no remarkable difference in other conventional risk factors (all P > 0.05). Hcy and high-sensitivity C-reactive protein (hs-CRP) levels were significantly higher in the CAD group than those in the control group (both P < 0.05). The FRS and estimated 10-year absolute CAD event risk were low in both groups and did not show a statistical difference. Multivariate logistic regression showed that male sex (odds ratio, OR, 3.68; 95 % confidence interval, 95 % CI, 1.54–10.01), smoking (OR, 2.54; 95 % CI, 1.15–5.36), TG (OR, 1.30; 95  % CI, 1.08–3.06), hs-CRP (OR, 3.74; 95 % CI, 1.72–12.21), and HHcy (OR, 2.03; 95 % CI, 1.26–5.83) were independently correlated with CAD in young patients.

Conclusion

HHcy is an important independent risk factor for CAD in young patients in southern China after adjusting for other risk factors.

Zusammenfassung

Hintergrund

Erhöhtes Plasmahomozystein (Hcy) gilt als Risikofaktor für koronare Herzkrankheit (KHK), ist aber immer noch umstritten. Mit der vorliegenden Studie wurde die Rolle von Hcy bei jungen Patienten mit KHK in Südchina untersucht.

Methoden

Insgesamt nahmen 146 konsekutive junge Patienten mit angiographischem KHK-Nachweis (Alter ≤ 55 Jahre) und 138 altersentsprechende Probanden ohne KHK als Kontrollgruppe an der Studie teil. Die Hcy-Werte wurden mit einem enzymatischen Assay gemessen. Eine Hyperhomozysteinämie war definiert als Hcy-Wert ≥ 15 µmol/l. Unter Einsatz des Framingham-Risikoscores (FRS) in seiner Modifikation durch das National Cholesterol Education Program Adult Treatment Panel III wurde das 10-Jahres-KHK-Risiko berechnet.

Ergebnisse

Es gab signifikante Unterschiede bei männlichem Geschlecht (p < 0,01), Raucheranamnese (p < 0,05) und Triglyzeridspiegeln (TG), (p < 0,05), aber keine nennenswerte Differenz bei anderen konventionellen Risikofaktoren (sämtliche p > 0,05) zwischen der KHK- und der Kontrollgruppe. Die Werte für Hcy und hochsensitives C-reaktives Protein (hs-CRP) waren in der KHK-Gruppe signifikant höher als in der Kontrollgruppe (beide p < 0,05). FRS und geschätztes absolutes 10-Jahres-KHK-Risiko waren in beiden Gruppen niedrig und wiesen keine statistische Differenz auf. Die multivariate logistische Regression zeigte, dass männliches Geschlecht (Odds Ratio, OR: 3,68; 95 %-Konfidenzintervall, 95%-KI: 1,54–10,01), Rauchen (OR: 2,54; 95 %-KI: 1,15–5,36), TG (OR: 1,30; 95 %-KI: 1,08–3,06), hs-CRP (OR: 3,74; 95 %-KI: 1,72–12,21) und HHcy (OR: 2,03; 95 %-KI: 1,26–5,83) bei jungen Patienten unabhängig mit KHK korreliert waren.

Schlussfolgerung

HHcy erweist sich nach Berücksichtigung anderer Risikofaktoren als wichtiger unabhängiger Risikofaktor für Patienten mit vorzeitiger KHK in Südchina.

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Acknowledgments

The project was supported by the Medical Scientific Research Grant of Health Ministry of Guangdong province, China (No: B2011310, A2012663), Scientific Research Fund of Foshan, Guangdong, China (No: 201108204, 201208210), and Scientific Research Fund of Shunde, Guangdong, China (No: 201208210). We thank Professor Lingxian Zhu and Doctor Dangdang Yu (majored in medical statistics, from Southern Medical University, China) for their great help in the statistical analysis.

Conflict of interest

On behalf of all authors, the corresponding author states that there are no conflicts of interest.

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Authors and Affiliations

  1. Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China

    Y. Wu, D. Xu &  S. Wu

  2. Department of Cardiology, The Affiliated Hospital at Shunde (the First People’s Hospital of Shunde), Southern Medical University, Shunde, PR China

    Y. Wu, Y. Huang, Y. Hu, J. Zhong, Z. He, W. Li & Y. Yang

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  1. Y. Wu
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Correspondence to S. Wu.

Additional information

Yanxian Wu and Yuli Huang contributed equally to this work.

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Wu, Y., Huang, Y., Hu, Y. et al. Hyperhomocysteinemia is an independent risk factor in young patients with coronary artery disease in southern China. Herz 38, 779–784 (2013). https://doi.org/10.1007/s00059-013-3761-y

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  • DOI: https://doi.org/10.1007/s00059-013-3761-y

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