The Relationship Between Plasma Homocysteine And Severity Of Coronary Lesion And Carotid Atherosclerosis

Objective:To investigate the relationship between plasma homocysteine and severity of coronary lesion and carotid atherosclerosis.Methods:91 patients(69 men and 22 women)were divided into coronary artery disease group(71 patient)and control group(20 patients)by the results of coronary angiography. Plasma total homocysteine concentration was determined by highperformance liquid chromatography(HPLC)method with fluorescence detection. Ultrasonographic scanning of the bilateral common carotid areries were performed,and the intima-medial thickness(IMT)was measured. IMT 1. 3mm was defined as atherosclerosis. Results:Ln-transformed plasma tHcy levels in coronary artery disease group and control group were 2.77+0.30 and 2.38+0.26 respectively,they were significantly different(P<0. 01).More cases of hyperhomocysteinemia were found in coronary artery disease patients than in the controls(46.4% vs 10% ,X2=12.1,P<0.01).The meanplasma total Hey levels in patients with lesions of zero and one two three vessels were singnificantly different(P<0.01). Plasma tHcy levels were the hightest in patients with three vessels lesions(P<0.01). Plasma tHcy levels in patients with lesion of one or two vessels were higher than those in controls(P<0.05),but no difference was noted between lesions of one and two vessels group(P>0.05). Multiple stepwise regression analysis showed that Ln-transformed plasma tHcy > fast blood glucose levels were independent associated with coronary artery Gensini scoring(R2=0.405,P=0.003). Ln-transfomed plasma tHcy levels were significantly higher in patients with IMT l. 3mm than those who with IMT<1. 3mm(2.72+0.36 vs 2.45+0.23,P<0. 01),Logistic regression analysis showed that plasma tHcy levels were associated with carotid atherosclerosis(OR=2.811,P=0.023 ,95% CI 1.131-4.724)independent of age and fast blood glucose concentration.Conclusion:Plasma tHcy levels were higher in coronary artery disease patients than the controls. More cases of hyperhomo-cysteinemia were found in coronary artery disease patients. There was a trend of increased tHcy levels with the range and lesion of coronaryartery. Plasma tHcy levels were higher in carotid disease patients than the controls. Plasma tHcy levels were independent factors of atherosclerosis.