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Association between Serum Homocysteine, Folate and B12 Concentration with Coronary Artery Disease in Thai Patients


Worachat Moleerergpoom MD*,
Thunyachai Sura MD**, Piyamitr Sritara MD***
* Division of Cardiology, Police General Hospital
** Division of medical genetics and molecular medicine, Faculty of Medicine Ramathibodi Hospital
*** Division of Cardiology,Faculty of Medicine, Ramathibodi Hospital


Background : Hyperhomocysteinemia, associated with low folate and low B12 levels, is known to be an
independent risk factor for atherosclerosis. Only a few available data has been demonstrated in Thai patients.
Objective : To evaluate serum fasting homocysteine, folate and B12 levels whether to see they are associated
with coronary artery disease (CAD).
Method and Result : Three hundred and one consecutive suspected CAD patients who underwent coronary
angiography at the Police General Hospital were studied. The mean age of the patients, 195 males and 106
females, was 63.0 + 10.0 year (range 39-85). A total of 218 patients were angiographically demonstrated as
having CAD. The mean serum homocysteine level of CAD patients had a non significant higher level than
those of 83 non CAD patients: 11.4 + 6.2 vs 10.2 + 4.2 umol/L, p = 0.06. Means of folate and B12 level in the
CAD patients and non CAD patients were 6.6 + 4.6 vs 7.0 + 4.3 nmol/L, p = 0.49 and 650.9 + 415.4 vs 613.3
+ 443.2 pmol/L, p = 0.56 respectively. No significant correlations were found between homocysteine with
folate and B12 levels. Logistic regression analysis showed a significant association between homocysteine
and CAD with OR = 1.08 (95%CI, 1.01-1.16), p = 0.03 after being adjusted for age, sex, DM, HT, history of
hyperlipidemia, smoking, BMI, folate and B12 levels. No significant association between homocysteine level
with the number of coronary vessel stenosis, age, BMI, DM, HT, smoking and history of hyperlipidemia was
observed in the present study.
Conclusion : Hyperhomocyteinemia, but not folate and B12 levels, may be an independent risk factor for
coronary artery disease in Thai patients

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