Total homocysteine in patients with angiographic coronary artery disease correlates with inflammation markers

Katharina  Schroecksnadel; Tanja B. Grammer; Bernhard O. Boehm; Winfried März; Dietmar Fuchs

doi:10.1160/TH09-07-0422

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2010; 103(05): 926-935
DOI: 10.1160/TH09-07-0422

Theme Issue Article

Schattauer GmbH

Total homocysteine in patients with angiographic coronary artery disease correlates with inflammation markers

Authors

Katharina Schroecksnadel

¹Division of Biological Chemistry, Biocenter, Innsbruck Medical University, Innsbruck, Austria
Tanja B. Grammer

²Synlab Center of Laboratory Diagnostics, Heidelberg, Germany
Bernhard O. Boehm

³Division of Endocrinology, Department of Medicine, University Hospital Ulm, Ulm, Germany
Winfried März

²Synlab Center of Laboratory Diagnostics, Heidelberg, Germany

⁴Clinical Department of Medical and Chemical Laboratory Diagnostics, Graz Medical University, Graz, Austria

⁵Mannheim Institute of Public Health, Chemical Faculty Mannheim, Ruprecht Karls University of Heidelberg, Heidelberg, Germany
Dietmar Fuchs

¹Division of Biological Chemistry, Biocenter, Innsbruck Medical University, Innsbruck, Austria

Abstract

Summary

Moderate hyperhomocysteinaemia is considered as an independent risk marker for cardiovascular disease and stroke. Earlier, increased homocysteine production was detected in stimulated immunocompetent cells in vitro, and several markers of inflammation like neopterin or C-reactive protein (CRP) were demonstrated as significant indicators of cardiovascular risk. The relationship between coronary artery disease (CAD), homocysteine metabolism and markers of immune activation and inflammation was investigated in a population of 1717 patients undergoing coronary angiography, recruited as participants of the LUdwigshafen RIsk and Cardiovascular Health (LURIC) study. 1325 patients (77.2%) suffered from coronary artery disease (CAD), which was was defined as the occurrence of a visible luminal narrowing (≥20% stenosis) in at least 1 of 15 coronary segments according to the classification of the American Heart Association, the remaining 392 individuals of the study population served as controls. Significant differences regarding systolic blood pressure, homocysteine, neopterin and folic acid concentrations were observed between patients and controls. Older age, decreased creatinine-clearance and higher concentrations of homocysteine and CRP were indicative for CAD. Low B-vitamin availability, therapy and the extent of immune activation strongly influenced homocysteine concentrations. Homocysteine concentrations were correlated with neopterin levels (r_s =0.325, p<0.001), and hyperhomocysteinaemic patients also presented with significantly higher CRP concentrations. Homocysteine accumulation coincided with impaired renal and heart function (as reflected by ProBNP[Brain natriuretic peptide]-concentrations). We conclude that homocysteine accumulation could result from B-vitamin deficiency which is related to chronic immune activation.

Keywords

Homocysteine - coronary artery disease - inflammation - neopterin - CRP

Full Text

References

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