Relevance of post-methionine homocysteine and lipoprotein (a) in evaluating the cardiovascular risk in young CAD patients

Rossella Marcucci, T. Brunelli, S. Fedi, G. Pepe, B. Giusti, A. M. Gori, D. Prisco, M. Falai, M. Margheri, R. Abbate, G. F. Gensini

Research output: Contribution to journalArticle

Abstract

Background: Aims of our study were to evaluate the prevalence of high lipoprotein (a) [Lp(a)] and homocysteine levels - both in the fasting state (FHcy) and post-methionine (PMHcy) - in young coronary artery disease (CAD) patients, and to investigate the role of genetic and environmental factors for hyperhomocysteinaemia. Materials and methods: We studied 140 patients with angiographically documented CAD (24 women ≤ 55 years and 116 men ≤ 50 years) and 140 healthy subjects as controls. Results: Both FHcy [13.2 (5.4-45.8) vs. 9.0 (5.1-24) μmol L-1); P <0.0001] and PMHcy [(39.4 (9.0-66.4) vs. 25.2 (16.4-33.9); P <0-0001] were significantly higher in patients than in controls. Lp(a) levels were significantly higher in patients than in controls (200 (3-1486) mg L-1 vs. 97 (10-412) mg L -1; P <0.0001). At the multivariate analysis, adjusted for the classical cardiovascular risk factors and creatinine levels, the OR (95% CI) for CAD at young age significantly increased in the fourth quartile of the distribution of FHcy, PMHcy and Lp(a) levels [FHcy: 14.9 (4.1-58), P <0.0001; PMHcy: 19.2 (4.0-86.3); P <0.0001; Lp(a): 19.6 (4.7-78.6): <0.0001]. Vitamin deficiencies were detected in 28/140 (20%) patients. The prevalence of the homozygous C677T (+/+) methylenetetrahydrofolatereductase genotype was higher, but not significantly different, in patients (22.8%) than in controls (18.6%). The allele frequency of the 844ins68 insertion variant in the cystathionine beta-synthase gene was 0.08 in the control group and 0.06 in the patient group. Conclusions: Results of the present study indicate the usefulness of including fasting and post-methionine Hcy, and Lp(a) determination in the diagnostic panels of young CAD patients, in order to obtain a better assessment of their cardiovascular risk profile.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalEuropean Journal of Clinical Investigation
Volume35
Issue number1
DOIs
Publication statusPublished - Jan 2005

Keywords

  • Genetic polymorphisms
  • Homocysteine
  • Lipoprotein (a)
  • Premature CAD
  • Risk factors
  • Vitamins
  • Young

ASJC Scopus subject areas

  • Medicine(all)

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    Marcucci, R., Brunelli, T., Fedi, S., Pepe, G., Giusti, B., Gori, A. M., Prisco, D., Falai, M., Margheri, M., Abbate, R., & Gensini, G. F. (2005). Relevance of post-methionine homocysteine and lipoprotein (a) in evaluating the cardiovascular risk in young CAD patients. European Journal of Clinical Investigation, 35(1), 1-7. https://doi.org/10.1111/j.1365-2362.2005.01439.x