The Correlation Of Plasma Homocysteine, Fibrinogen And Coronary Heart Disease

Objective: To investigate if hyperhomocysteinemia is an independent risk factor associated with coronary heart disease (CHD) in Chinese and examine the role of plasma fibrinogen and those conventional risk factors for atherosclerosis in CHD. The relationships among plasma homocysteine, fibrinogen and the severity of coronary arteries, those conventional risk factors for atherosclerosis were also examined.Methods: Patients with CHD (n=137) presenting with confirmed acute myocardial infarction (AMI) (n=67) or unstable angina pectoris (UAP) (n=70) were consecutively recruited together with patients (n=41) in whom the presenting chest pain was not of cardiac origin, included as controls. The diagnoses of UAP and controls were confirmed by coronary angiography. The severity of coronary arteries was quantified using coronary artery scoring on the basis of prior reports, and subjects were graded as nonstenotic, stenotic single-vessel, stenotic double- vessel, or stenotic triple-vesselbased on the number of stenotic coronary artery. Plasma samples were collected on admission. The fasting plasma homocysteine was assayed by enzyme immunoassay. Plasma fibrinogen and serum lipid profile were also measured.Results: Total fasting homocysteine concentrations were significantly higher in the patient group (18.37 9.58 mol/1) than in the control subjects (10.62 5.78 mol/1; p<0.001). There was a significant higher incidence of hyperhomocysteinemia in patient group than in control group (42.33% versus 9.76%; p<0.01). Based on multiple stepwise logistic regression analysis: the relative ratio (RR) of homocysteine to CHD was 1.14(p<0.001), the final model also consisted of fibrinogen, smoking and diabetes mellitus. Plasma fibrinogen level in CHD patients significantly exceeded those of control subjects (3.87 1.13 vs 2.78 0.64g/L; p<0.001). The relative ratio of fibrinogen to CHD was 3.44 (p<0.001). The level of homocysteine was not associated with that of fibrinogen, its correlation coefficient was 0.102(p>0.05). There was no significantly correlation between the level of homocysteine or fibrinogen in patients and the extent of coronary stenosis. The levelof homocysteine or fibrinogen in patients association with age, gender, lipid profile and other traditional CHD risk factors was not found.Conclusions: Hyperhomocysteinemia and fibrinogen are both independent risk factors for CHD in Chinese, and they may play an important role in the occurrence of CHD events.