Homocysteine and major coronary events: a prospective population study amongst women

Objectives. To study serum homocysteine concentration for its prediction of major coronary heart disease events amongst women. Design. A case-control study nested within a follow-up study. Subjects. A total of 74 and 75 major coronary events (coronary deaths or no nfatal myocardial infarction) which occurred in women with and without know n heart disease, respectively, during a 13-year follow-up and two individua lly matched controls per case. Main outcome measure. Major coronary event. Results. Amongst women with baseline heart disease, the relative risk (95% CI) of such events, adjusted for age, smoking, hypertension, diabetes, seru m cholesterol and body mass index, was 3.32 (1.05-10.5) in the highest homo cysteine quintile compared with the lowest quintile. Amongst women free of heart disease at baseline, the corresponding relative risk value was 0.77 ( 0.24-2.45). Conclusions. This prospective study support the hypothesis that homocystein e is a risk factor for coronary events in women with heart disease.