Assessment of total plasma homocysteine and nitric oxide levels as a risk factors in coronary heart disease

ABSTRACT

This study was performed on 40 patients suffering from Coronary heart disease [CHD] and 20 primary asymptomatic hyperlipidemia subjects compared with 20 age and sex matched healthy persons as a control group [group I]. Patients were classified into three groups Group III Twenty patients with acute myocardial infarction [AMI]. Group II Twenty patients [6 with stable angina [group III[a]], and 14 with unstable angina [group III[b]] Group IV Twenty patients with primary hyperlipidemia, without clinical and ECG evidences of ischaemic heart disease [IHD]. All patients and control groups were subjected to clinical examination, ECG serum glucose level, Kidney, liver function tests, lipogram, CK, CK-MB and C-reactive protein, nitric oxide, [NO] and Total plasma homocysteine [tHcy] Serum total cholesterol and LDL-c levels showed statistically significant elevation in groups II, III and IV when compared with the control group. Also, serum CH, LDL-c and Triglyceride [TG] showed highly significant elevation in group IV when compared with group II and III while 9 TG was signficantly elevated only in group III compared with control Serum HDL-c revealed statistically significant reduction in all patient groups when compared to the control group, but no significant difference was observed on comparing different patient groups together. CK, CK-MB and CRP levels revealed highly significant elevation in group II and group III[b], and group IV when compared with the control group. No significance difference was observed on comparing group III[a] with the control group. Also the same parameters showed significant elevation in group II when compared with groups III[a] III[b] and IV. Also there was highly significant elevation in group III[b] when compared with group IV. But no significant difference was observed on comparing group III[a] with group IV. Serum nitric oxide [NO] revealed highly significant elevations in groups III[a], III[b] and IV when compared with the control group, while no significant difference was observed between group II and the control group. Serum NO level showed no significant difference in other patient groups when compared with each other. Homocysteine showed highly significant elevation in all patient groups when compared with the control group. In group II plasma tHcy levels showed significant elevation when compared with groups III[a],III[b] and IV. Moreover patients in group III[b] showed significant elevation when compared to group IV. Hyperhomocysteinemia is found in most of the patients with CHD and in cases of primary hyperlipidemia. So tHcy can be used as a risk factor for prediction of CHD. Also it is related to severity of CHD as it showed the highest sensitivity in AMI