Conditional risk factors in men with previous myocardial infarction: relevance of C3 and homocysteine

Objective - To establish which traditional and conditional risk factors wer e effectively treated, and which remained active, in patients with previous myocardial infarction (PMI). Methods and results - In 47 PMI patients recently submitted to cardiologica l assessment and in 42 controls (50-70 years old men), traditional risk fac tors (total cholesterol, high-density lipoprotein cholesterol, blood glucos e, blood pressure, cigarette smoking and body mass index) and the following variables were measured: fibrinogen, plasminogen activator inhibitor-1 (FA I-1), lipoprotein(a) [Lp(a)], total homocysteine, plasma folates, vitamin B 12, high sensitivity C-reactive protein and C3 complement. Most patients w ere taking beta-blockers, ACE inhibitors and statins. Accordingly, patients had lower blood pressure and cholesterol values than controls. Moreover, t hey consumed less alcohol and coffee and did not differ from controls in ci garette smoking and body mass index. Conversely, patients had higher levels of homocysteine, fibrinogen, C3 complement and Lp(a), although of these fa ctors only C3 and homocysteine remained significantly associated with PMI i n multivariate analysis. C-reactive protein, PAI-1 and especially C3 often correlated with traditional risk factors in controls, but these correlation s tended to disappear or reverse in PMI patients. Fibrinogen inversely corr elated with alcohol consumption. Homocysteine correlated (inversely) with p lasma folates only. Lp(a) did not correlate with any variable. Conclusions - Forty-seven patients with previous myocardial infarction disp layed an excellent control of traditional risk factors, but they had higher mean C3 and homocysteine levels than the control group.