Homocysteine/coronary atherosclerosis and cardiac transplantation:a case control study

Abstract

Accelerated coronary atherosclerosis (CAD)is a rate limiting process in the long term success of cardiac trnasplantation (CTx). Hyperhomocysteinemia (HC) is a major risk factor for vascular disease including CAD. We have hypothesized that HC is a major contributing risk factor in transplant coronary artery disease (TxCAD). We measured fasting serum total homocysteine and creatinine levels in cardiac transplant patients (n=24) and compared them with age and sex matched patients (n=19) with ischemic cardiomyopathy (controls, C). Serum homocysteine levels were found to be significantly elevated (19.27±7.05 umol/l)in cardiac transplant patients when compared with controls. (12.56±5.42 umol/l, p<0.001). Serum homocysteine levels did not correlate with serum creatinine (range 0.8-8.2 mg/dl) in cardiac transplant patients (r=0.065) while a strong correlation was found to exist between serum creatinine and homocysteine levels in the control group (r=0.83). There was no correlation between serum homocysteine levels and duration of cardiac transplantation(range 0.5-15 years). There was a strong correlation between homocysteine and CAD in the cardiac transplant patients and no correlation in the controls.