Influence of serum homocysteine level on coronary atherosclerosis in Japanese

Abstract This study investigated the relationship between serum homocysteine level and coronary artery disease in Japanese. Serum homocysteine level was measured in 200 consecutive patients who underwent coronary angiography for the assessment of ischemic heart disease. Patients with acute myocardial infarction were excluded, so 197 patients were included in this study. The patients were classified into four groups based on number of diseased vessels identified by coronary angiography: no significant stenosis group (non-vessel group), one-vessel group, two-vessel group, and three-vessel group. More than 50% stenosis was defined as diseased vessels. Serum homocysteine level in the three-vessel group (13.5 +/- 8.0 microM) was significantly higher than that in the non-vessel group (9.9 +/- 2.7 microM), one-vessel group (9.1 +/- 2.3 microM), and two-vessel group (10.4 +/- 3.3 microM). Patients were classified into quartile groups according to the serum homocysteine level. The number of diseased vessels and frequency of three-vessel disease tended to be higher with increasing serum homocysteine level. There was no significant relationship between serum homocysteine level and coronary risk factors (diabetes mellitus, hyperlipidemia, smoking habit) except hypertension. Multivariate analysis for the predictor of number of diseased vessels showed diabetes mellitus, hypertension, and serum homocysteine level were independent predictors. Elevation of plasma homocysteine level is related to the severity of coronary artery disease in Japanese.