Clinical relevance of plasma homocysteine levels in Taiwanese patients with coronary artery disease.

Homocysteine (Hcy) has recently been considered as a risk factor for cardiovascular disease. Coronary artery disease (CAD) is the third most common cause of mortality in Taiwan. The objective of our present study is to delineate the relationship between the plasma Hcy level and CAD in Taiwanese using an improved enzymatic method. Blood samples were collected from 86 CAD patients, which include 38 patients with acute coronary syndrome (ACS) and 48 patients with stable CAD, and 89 controls. Plasma Hcy levels were measured by HPLC and enzymatic methods. Plasma Hcy levels were 8.27 +/- 1.74, 8.50 +/-1.88 and 11.76 +/- 4.58 muM in normal controls, patients with stable CAD and those with ACS, respectively. Plasma Hcy levels were elevated in the cohort of ACS patients, as compared with those of normal controls or patients with stable CAD. Within the CAD group, patients with the highest quartile Hcy level (10.18-23.73 muM) had a significantly higher odd ratio for ACS, as compared with those with the lowest quartile Hcy level after multivariate adjustment. Plasma Hcy concentration can be used as an independent risk factor of ACS, particularly for those with a history of CAD. Moreover, our improved enzymatic assay can be automated for large-scale screening of high-risk cohorts.