Association between Plasma Homocysteine Concentrations and Carotid Intima-Media Thickness in Patients with Coronary Artery Disease

Introduction: Although homocysteine has atherogenic and prothrombotic properties, the conflicting results from studies made its role in coronary artery disease unclear. Objectives: The aim of this study was to evaluate the association between plasma levels of homocysteine and carotid atherosclerosis in patients with angiographically confirmed coronary artery disease. Methods: This prospective study comprised 201 consecutive patients with angiographically confirmed coronary artery disease (CAD) that were divided in three groups considering the presence of vascular affection: 126 patients with monovascular disease (MONO group), 42 patients with bivascular disease (BI group) and 33 patients with trivascular disease (TRI group). The three groups were compared with a control group formed by 41 apparently healthy subjects. We measured serum lipid profile and serum homocysteine levels in all patients. The carotid intima-media thickness (carotid IMT) was determined by ultrasound imaging according to Manheim consensus. Results: Patients from TRI group had significantly higher levels of total cholesterol, triglycerides and LDLcholesterol compared with patients from BI group, MONO group and CONTROL group (all p<0.001). We observed statistically significant differences between mean values of HC between TRI and BI groups (p = 0.03), TRI and MONO groups (p <0.001) and BI and MONO groups (p = 0.011). We observed a moderate significantly correlation between carotid IMT and plasma levels of homocysteine (r=0.409, p<0.001). Conclusion: The study showed an association between plasma homocysteine levels and carotid IMT in patients with angiographically confirmed coronary artery disease. Future studies are necessary to apprehend the effects of homocysteinemia on vascular endothelium. Key-Words: homocysteine, intima-media thickness, endothelial dysfunction, oxidative stress