Homocysteine levels and coronary heart disease in Syria

ABSTRACT

Coronary artery disease and disturbances of lipid levels are common in Syria. To assess homocysteine as a cardiovascular risk factor, we compared 133 men with angiographically documented coronary heart disease with 130 age-matched asymptomatic men. Cases had more hypertension and diabetes and higher levels of total cholesterol, low-density lipoprotein cholesterol, triglycerides, fibrinogen, and homocysteine than did controls. The homocysteine level distribution of cases was shifted toward higher concentrations [p < 0.05] compared with those in controls. When patients with one-vessel, two-vessel, and three-vessel disease were compared, only levels of fibrinogen and homocysteine were associated with the numbers of vessel involved. Homocysteine level was not correlated to fibrinogen and lipid concentrations. A multiple regression analysis revealed that only age [p = 0.06] and smoking [p = 0.04] were marginally related to homocysteine concentrations. Homocysteine concentrations in cases were significantly different than those in controls, even after adjustment for all covariates [p < 0.006]. In conclusion, hyperhomocysteinemia is independently associated with coronary artery disease in Syrian men. Furthermore, fibrinogen concentrations are also an important risk factor for Syrian men