Serum homocysteine does not associate with uncomplicated coronary heart disease

Background Elevated serum homocysteine concentrations have been related to coronary heart disease. However, the association has not indisputably been proven, and the mechanisms by which homocysteine may be atherogenic have on ly partially been elucidated. The objective of the present study was to inv estigate whether serum homocysteine is associated with angina pectoris and myocardial infarction. Methods We compared serum homocysteine concentrations in subjects with clin ical evidence of angina pectoris or history of myocardial infarction to age -matched controls. The study included 248 males, who participated in a larg e cross-sectional risk factor survey carried out in five geographic areas i n Finland. Results Serum homocysteine concentration was significantly higher in subjec ts with a history of myocardial infarction compared to controls (15.3 mu mo l L-1 and 13.9 mu mol L-1 respectively, P = 0.037). In a logistic regressio n model including several cardiovascular risk factors, serum homocysteine w as significantly associated with myocardial infarction (95% CI 1.0157-1.299 0, P = 0.027). Serum homocysteine concentrations did not differ between sub jects with angina pectoris and age-matched controls (13.9 mu mol L-1 and 14 .2 mu mol L-1 respectively). Conclusions Our results suggest that elevated serum homocysteine is associa ted with myocardial infarction but not with uncomplicated coronary heart di sease.