802-5 High Homocysteine Concentrations: An Independent Risk Factor for Coronary Atherosclerosis in Women

Abstract

High plasma homocysteine concentration is a significant risk factor for premature vascular disease in men, but the role in determining coronary disease risk in women remains unclear. Risk factors, including hypertension, hypercholesterolemia, smoking, and diabetes were recorded in 228 patients (175 men, 53 women) with angiographically documented coronary disease (≥70% stenosis of at least one major coronary vessel), and 223 healthy controls (181 men, 42 women), Fasting total plasma homocysteine was measured in all subjects. A high homocysteine concentrations was defined as a level greater than the 80th percentile, adjusted for gender. In univariate analysis, homocysteine correlated with age, but not smoking, hypertension or hypercholesterolemia. Homocysteine values and odds ratios based upon multivariate analysis were: Women Men Patients Controls Patients Controls Age 62 ± 12 * 53 ± 10 61 ± 11 * 51 ± 10 Homocysteine Level( μ mol/L) 127 ± 4.4 * 102 ± 4.9 13.1 ± 4.3 * 11.3 ± 30 Percent High Homocysteine 55 * , † 20 35 * 20 Odds Ratio 3.2 * NA 1.9 * NA Confidence Interval 1.2-8.4 NA 11-33 NA * p < 0.01 vs controls † p < 0.05 vs male patients Mean homocysteine concentrations are higher in women with coronary disease than age and sex matched controls. High homocysteine levels are more frequently seen in women than men and confer an independent three-fold incremental risk of CAD.