Homocysteine Levels and Coronary Heart Disease in Syria

BACKGROUND: Coronary artery disease and disturbances of lipid levels are common in Arab countries. OBJECTIVE: To assess homocysteine as a cardiovascular risk factor. METHOD: We compared 133 men with angiographically documented coronary heart disease with 130 age-matched asymptomatic men. RESULTS: Cases had more hypertension and diabetes and higher levels of total cholesterol, low-density lipoprotein cholesterol, triglycerides, fibrinogen, and homocysteine than did controls. The homocysteine level distribution of cases was shifted toward higher concentrations (P < 0.05) compared with those in controls. When patients with one-vessel, two-vessel, and three-vessel disease were compared, only levels of fibrinogen and homocysteine were associated with the numbers of vessels involved. Homocysteine level was not correlated to fibrinogen and lipid concentrations. A multiple regression analysis revealed that only age (P = 0.06) and smoking (P = 0.04) were marginally related to homocysteine concentrations. Homocysteine concentrations in cases were significantly different than those in controls, even after adjustment for all covariates (P < 0.006). CONCLUSION: Hyperhomocysteinemia is independently associated with coronary artery disease in Arab men. Furthermore, fibrinogen concentrations are also an important risk factor for Arab men.