Research article

Homocysteine, vitamin B12 and folate levels in premature coronary artery disease

Saeed Sadeghian¹ , Faramarz Fallahi² , Mojtaba Salarifar³ , Gholamreza Davoodi¹ , Mehran Mahmoodian⁴ , Nader Fallah⁵ , Soodabeh Darvish⁴ , Abbasali Karimi⁶ and Tehran Heart Center

¹Assistant Professor of Cardiology, Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran

²Assistant Professor of Cardiology, Shahed University, Tehran, Iran

³Assistant Professor of Interventional Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran

⁴Researcher, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran

⁵Regular member of board, Department of Biostatistics, Shahed University, Tehran, Iran

⁶Associated Professor of cardiac surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran

author email corresponding author email

BMC Cardiovascular Disorders 2006, 6:38doi:10.1186/1471-2261-6-38

Published:	26 September 2006

Abstract

Background

Hyperhomocysteinemia is known as an independent risk factor of atherosclerosis, but the probable role of hyperhomocysteinemia in premature Coronary Artery Disease (CAD) is not well studied. The aim of this study was to assess the role of hyperhomocysteinemia, folate and Vitamin B12 deficiency in the development of premature CAD.

Methods

We performed an analytical case-control study on 294 individuals under 45 years (225 males and 69 females) who were admitted for selective coronary angiography to two centers in Tehran.

Results

After considering the exclusion criteria, a total number of 225 individuals were enrolled of which 43.1% had CAD. The mean age of participants was 39.9 +/- 4.3 years (40.1 +/- 4.2 years in males and 39.4 +/- 4.8 years in females). Compared to the control group, the level of homocysteine measured in the plasma of the male participants was significantly high (14.9 +/- 1.2 versus 20.3 +/- 1.9 micromol/lit, P = 0.01). However there was no significant difference in homocysteine level of females with and without CAD (11.8 +/- 1.3 versus 11.5 ± 1.1 micromol/lit, P = 0.87). Mean plasma level of folic acid and vitamin B12 in the study group were 6.3 +/- 0.2 and 282.5 +/- 9.1 respectively. Based on these findings, 10.7% of the study group had folate deficiency while 26.6% had Vitamin B12 deficiency. Logistic regression analysis for evaluating independent CAD risk factors showed hyperhomocysteinemia as an independent risk factor for premature CAD in males (OR = 2.54 0.95% CI 1.23 to 5.22, P = 0.01). Study for the underlying causes of hyperhomocysteinemia showed that male gender and Vitamin B12 deficiency had significant influence on incidence of hyperhomocysteinemia.

Conclusion

We may conclude that hyperhomocysteinemia is an independent risk factor for CAD in young patients (bellow 45 years old) – especially in men -and vitamin B12 deficiency is a preventable cause of hyperhomocysteinemia.