Homocysteinemia as an independent risk factor in the Chinese population at a high risk of coronary artery disease.

In this study, we examined whether homocystinemia acted as an independent and important risk factor in the Chinese population at a high risk of coronary artery disease (CAD). The study population included 237 consecutive patients undergoing coronary angiography and was divided into 2 groups. Group A consisted of 138 patients with CAD and group B of 99 patients with normal coronary angiogram. Prevalence of conventional risk factors of CAD including aging, male gender, family history of CAD, smoking, hypertension, dyslipidemia, diabetes, obesity, and increased high-sensitivity C-reactive protein (hs-CRP) was derived and fasting plasma homocysteine was measured. Results showed that level of plasma fasting homocysteine in group A was significantly higher compared with that in group B and homocystinemia was more prevalent in group A than in group B (p <0.001 for the 2 comparisons). Levels of systolic and diastolic blood pressures, fasting serum glucose, total cholesterol, triglycerides, low-density lipoprotein cholesterol, and hs-CRP were higher, whereas level of high-density lipoprotein cholesterol was lower (all p value <0.05) in group A than in group B. Using a multivariate logistic regression model, we identified smoking, hs-CRP, total cholesterol, plasma homocysteine, systolic blood pressure, and high-density lipoprotein cholesterol as independent risk or protective factors of CAD with odds ratios of 3.83, 3.15, 2.51, 2.14, 1.08, and 0.02, respectively. In conclusion, a high homocysteine level is an independent and important risk factor of CAD and the relative risk of CAD conferred by homocystinemia is similar to that of dyslipidemia in the Chinese population at high risk of CAD.