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Homocysteine and coronary artery disease

BERN, SWITZERLAND. There is substantial evidence that high levels of homocysteine (a sulphur- containing amino acid) are directly associated with an increased risk of cardiovascular disease. It is believed that homocysteine causes damage to the lining of the arteries and thereby promotes atherosclerosis and hypertension. The normal range of homocysteine in adults is between 5 and 15 micromol/L. An excess of just 5 micromol/L has been found to correspond to an increased risk of coronary artery disease of 60 per cent in men and 80 per cent in women.

A team of American and Swiss researchers now reports that the severity of cardiovascular disease, as indicated by the number of arteries affected, is directly proportional to the homocysteine level. The study involved 631 patients who had been referred for coronary angiography. The patients had their homocysteine levels measured and an angiogram taken. The researchers found that homocysteine levels increased in a linear fashion from 9.2 micromol/L for patients with no coronary disease to an average of 12.4 in patients with three-vessel disease. The researchers also noted that men were far more likely to have blocked arteries than women. Age, smoking, hypertension, and high cholesterol levels were other significant risk factors for coronary artery disease found in the study. The researchers recommend routine testing of homocysteine levels as an important factor in evaluation risk for coronary artery disease.
Schnyder, Guido, et al. Association of plasma homocysteine with the number of major coronary arteries severely narrowed. American Journal of Cardiology, Vol. 88, November 1, 2001, pp. 1027-30

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