Association between total homocyst(e)ine and the likelihood for a history of acute myocardial infarction by race and ethnicity: Results from the Third National Health and Nutrition Examination Survey
Wh. Giles et al., Association between total homocyst(e)ine and the likelihood for a history of acute myocardial infarction by race and ethnicity: Results from the Third National Health and Nutrition Examination Survey, AM HEART J, 139(3), 2000, pp. 446-453
Citations number
36
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Background Few studies examining the association between total homocyst(e)i
ne and coronary heart disease have included blacks or Hispanics.
Methods Data from the third National Health and Nutrition Examination Surve
y (3173 patients), a nationally representative survey of US adults, were us
ed to examine the relation between total homocyst(e)ine and an electrocardi
ogram or a physician's diagnosis of acute myocardial infarction (259 patien
ts) among whites, blacks, and Mexican Americans greater than or equal to 40
years aid.
Results Vitamin B-12 and serum folate concentrations were significantly low
er among persons with a total homocyst(e)ine concentration greater than or
equal to 15 mu mol/L than among those with a total homocyst(e)ine concentra
tion less than or equal to 10 mu mol/L. Persons with a total homocyst(e)ine
concentration greater than or equal to 15 mu mol/L were also older and mor
e likely to be hypertensive, have a higher cholesterol concentration, and s
moke. Compared with persons with a total homocyst(e)ine concentration less
than or equal to 10 mu mol/L, persons with a concentration greater than or
equal to 15 mu mol/L had an odds ratio (OR) for myocardial infarction of 1.
8 (95% confidence interval [CI], 1.2-2.9) after adjustment for cardiovascul
ar disease risk factors. Similar associations were noted among whites (OR 1
.8, 95% CI, 1.1-3.1) and blacks (OR 1.9, 95% CI, 0.8-4.2); a more modest as
sociation was noted among Mexican Americans (OR 1.2, 95% CI, 0.3-5.0). The
association between total homocyst(e)ine and myocardial infarction was also
more pronounced in persons without hypertension or diabetes.
Conclusions Almost a 2-fold increased likelihood of myocardial infarction a
mong persons with a total homocyst(e)ine concentration greater than or equa
l to 15 mu mol/L was noted in this nationally representative survey. The ma
gnitude of the association did not differ by race or ethnicity.