RESUMO
Objective: to study the possible role of homocysteine and lipoprotein [a] as risk factors for premature coronary artery disease [CAD], and to assess their relationship to conventional risk factors
Subjects and Methods: 45 subjects were divided into 3 groups, 15 premature CAD patients without traditional cardiovascular risk factors, 15 premature CAD patients with one or more traditional cardiovascular risk factors [hypertension, diabetes mellitus, cigarette smoking, or dyslipidemia] and 15 healthy normal subjects matched for age and sex [controls]. All were subjected lo estimation of plasma homocysteine [Hcys], plasminogen activator inhibitor-1 [PAI-1] by ELISA, plasma folic acid by radioimmunoassay, plasma lipoproteine a [Lp[a]] by turbidimetry and plasma lipids by colorimetry
Results : this study showed a significant elevated Hcys and low folate levels in premature CAD patients. Significant correlations found between elevated level of PAI-1 and CAE in the two patient groups. There were significant positive correlations between plasma Hcys and that of PAI-I and LDL-C and significant negative correlations between plasma Hcys and that of folate and HDL-c in the patient groups. Plasma Lp[a] was only significantly elevated in premature CAD patients with traditional risk factors
Conclusion : Hcys, folic acid and PAI-1 might serve as independent risk factors for premature CAD in patients with and without traditional coronary risk factors. However. Lp[a] might confer an additional coronary risk factor only in the presence of traditional risk factors