Elevated Serum Homocysteine in Patients with Coronary Vasospasm

Han, Seong Woo; Ryu, Kyu Hyung; Lee, Yung

Abstract

BACKGROUND
Homocysteine is a metabolite of methionine with atherogenic properties via endothelial dysfunction. Endothelial dysfunction is one of main pathophysiologic mechanisms of coronary vasospasm. We examined the relationship between the risk of patients with coronary vasospasm and serum total homocysteine (tHcy), folate, vitamin B12, and plasma vitamin B6.
METHODS
Fasting serum tHcy, folate, vitamin B12, and plasma vitamin B6 concentrations were measured in 25 patients (15 men, age 52.8+/-10.1) with coronary vasospasm and compared with 22 healthy control subjects matching in age and sex (10 men, age 52.7+/-9.2). Serum tHcy concentration was higher in the vasospasm group than in the control group (14.8+/-5.3 vs 10.1+/-2.5 micromol/L, p<0.001).
RESULTS
Serum folate (6.3+/-1.0 vs 10.2+/-4.5 ng/mL, p<0.001) and vitamin B12 concentration (544.8+/-181.7 vs 1004.9+/-567.1 pg/mL, p<0.001) were lower in vasospasm group. There was no significant difference in plasma vitamin B6 concentration between the two groups (77.8+/-44.3 and 95.8+/-63.4 nmol/L).
CONCLUSION
These data support the hypothesis that elevated serum tHcy is a risk factor for coronary vasospasm. Low folate and vitamin B12 levels in patients with coronary vasospasm suggest that these agents contribute therapeutically to the treatment of patients with coronary vasospasm.