The Relationship of Homocysteine, Vitamin B12, Vitamin B6 and Folate with Ischemic Heart Disease

ABSTRACT

BACKGROUND AND OBJECTIVES: An elevated serum homocysteine level is a risk factor of atherosclerosis. The relationship between homocysteine and antioxidant vitamins, and other cardiovascular risk factors, and between cardiovascular patients and controls, were evaluated. SUBJECTS AND METHODS: The study population consisted of 146 patients, with objectively first diagnosed ischemic heart disease, and 146 healthy sex and age matched controls. The serum levels of homocysteine, folate, vitamin B12 and vitamin B6 were measured. The correlation between the serum levels of homocysteine and those of folate, vitamin B6 and vitamin B12 were also evaluated. RESULTS: The serum homocysteine concentrations were significantly higher in the cardiovascular patients than in the matched controls (13.35+/-0.51 mmol/l vs. 11.43+/-0.37 mmol/l, p=0.003). However, there was no significant difference between the stable angina, unstable angina and myocardial infarction subgroups. From a multivariate analysis, the elevated homocysteine level was still associated with a low folate level (patient group;r=-0.380, p=0.000, control group;r=-0.229, p=0.000). The measured vitamin B12 level showed no correlation with the homocysteine level in the cardiovascular patients, but did in the controls (R2=0.066, p<0.05). The measured levels of vitamin B6 showed no correlation with the homocysteine level in either group. CONCLUSION: The serum homocysteine level was inversely correlated with the serum folate level; therefore, folic acid supplementation would be expected to improve the endothelial function, and may also reduce cardiovascular events in patients with ischemic heart disease.