Moderate hyperhomocyst(e)inemia is associated with the presence of coronary artery disease and the severity of coronary atherosclerosis in Koreans

To examine whether moderate hyperhomocyst(e)inemia is associated with coron ary artery disease and the number of diseased coronary vessels in Koreans, we investigated 201 patients with angiographically documented coronary arte ry disease and 187 healthy subjects without evidence of stroke and coronary artery disease. The mean plasma total homocysteine in patients was higher than in controls (10.3 mu mol/L; 95% confidence interval, 7.0-13.6 vs. 8.9 mu mol/L; 6.0-11.8) (p=0.005). The prevalence of moderate hyperhomocyst(e)i nemia, defined as the top 90th percentile in controls (13.2 mu mol/L), was higher in patients than in controls (23.9% vs. 10.2%, p=0.001). Plasma homo cyst(e)ine levels were not correlated to age, body mass index, levels of se rum cholesterol, creatinine, and uric acid. Based on multiple logistic regr ession analyses with adjustment for total cholesterol, hypertension, smokin g status, diabetes, age, and body mass index, the adjusted odds ratio of mo derate hyperhomocyst(e)inemia for coronary artery disease was 1.53 (95% con fidence interval: 1.39-1.65, p=0.0001). Moderate hyperhomocyst(e)inemia, di abetes mellitus, and old age were more prevalent in patients with triple-ve ssel disease than in single- or double-vessel disease (p=0.02). Multiple lo gistic regression analysis revealed that moderate hyperhomocyst(e)inemia wa s a significant predictor of triple-vessel disease with odds ratio of 2.78 (95% confidence interval: 1.08-7.10, p=0.02). We conclude that moderate hyp erhomocyst(e)inemia is an independent risk factor for coronary artery disea se, and also related significantly to the presence of triple-vessel disease . (C) 1999 Elsevier Science Ltd. All rights reserved.