Prognostic value of homocysteine and vitamin D for patients with ischemic heart disease and multifocal atherosclerosis
DOI:
https://doi.org/10.14739/2310-1210.2018.1.121880Keywords:
myocardial ischemia, homocysteine, hyperhomocysteinemia, vitamin D, dyslipoproteinemiaAbstract
Cardiovascular system diseases (CSD) – is one of the most acute medical and social problems of modern society. Ischemic heart disease (IHD) and acute disturbance of cerebral circulation were and remain the leading cause of death and disability.
At present, it has been established that in the progression of IHD and its complications, an increase in the level of homocysteine and deficiency of vitamin D are essential.
Purpose of the study: to study the effect of hyperhomocysteinemia and deficiency of vitamin D on the course of atherosclerosis and ischemic heart disease.
Materials and methods: the study analyzed laboratory data from 58 patients with atherosclerosis. Depending on the prevalence of atherosclerosis patients were divided into 2 groups. All those examined had vitamin D deficiency, as well as hyperhomocysteinemia. These changes were more pronounced in patients with multifocal atherosclerosis, which required a more thorough medication correction after surgical intervention on the coronary and carotid arteries.
Results: Of practical interest is the analysis of blood plasma homocysteine concentration values depending on the localization of atherosclerotic lesion. In our study, in the first group, the median plasma homocysteine concentration was significantly higher.
Moreover, there was a strong correlation between high concentrations of homocysteine and advanced atherosclerotic lesions. These results may indicate a possible destabilization of atherosclerosis course with hyperhomocysteinemia in combination with vitamin D deficiency.
Patients of the first group with multifocal atherosclerosis had significantly higher homocysteine indices and a more pronounced vitamin D deficiency. No less important is the fact that in the examined patients both in one group and in the other group a significant vitamin D deficiency was detected.
Conclusions: Hyperhomocysteinemia and vitamin D deficiency – are risk factors for the development of coronary heart disease and are associated with an unfavorable course of coronary pathology. All patients with ischemic heart disease had vitamin D deficiency and hyperhomocysteinemia, more pronounced with multifocal atherosclerosis, which should be considered when prescribing medication after myocardial revascularization.
References
Nehler, M. R., Teylor, L. M. Jr., Porter, J. M. (1997) Homocysteinemia as a risk factor for atherosclerosis: a review Homocysteinemia kak faktor riska ateroskleroza: obzor. Kardiovask. Surg., 6, 559–567.
Dietrich-Muszalska, A., Malinowska, J., Olas, B., Głowacki, R., Bald, E., Wachowicz, B., & Rabe-Jabłońska, J. (2012) The oxidative stress maybe inducedby the elevated homocysteine in schizophrenic patients. Neurochem. Res., 37(5), 1057–62. doi: 10.1007 / s11064-012-0707-3.
McCully, K. S. (1969) Vascular pathology of homocysteinemia: implications for thepathogenesis of arteriosclerosis. Amer. J. Patologiya., 56(1), 111–128.
Wang, H., Fan, D., Zhang, H., Fu, Y., Zhang, J., & Shen, Y. (2006) Serumlevel homocysteineis, korrelirovannyy s sonnoy arteriiteroznym klerosinom, kitayskiy s khimicheskim shokom. Neurol. Res., 28, 25–30.
Kassi, E., Adamopoulos, C., Basdra, E. K., & Papavassiliou, A. G. (2013) Role of Vitamin D in Atherosclerosis. Circulation, 128, 2517–2531. doi: 10.1161/CIRCULATIONAHA.113.002654
Nygård, O., Vollset, S. E., Refsum, H., Stensvold, I., Tverdal, A., Nordrehaug, J. E., et al. (1995) Total plasma homocysteine and cardiovascular risk profile. The Hordaland Homocysteine Study. JAMA, 274, 1526–1533.
Bilsborough, W., Green, D. J., Mamotte, C. D. S., van Bockxmeer, F. M., O'Driscoll, G. J., & Taylor, R. R. (2003) Endothelial nitric oxidesynthasegene polymorphism, homocysteine, cholesterol and vascular endothelial function. Atherosclerosis, 169(1), 131–138. doi: 10.1016/S0021-9150(03)00147-3
Kanani, P. M., Sinkey, C. A., Browning, R. L., Allaman, M., Knapp, H. R., & Haynes, W. G. (1999) Role of oxidant stress in endothelial dysfunction produced by experimental hyperhomocysteinemia in humans. Circulation, 100(11), 1161–1168. doi: 10.1161/01.CIR.100.11.1161
Cavalca, V., Cighetti, G., Bamonti, F., Loaldi, A., Bortone, L., Novembrino, C., et al. (2001) Oxidative stress and homocysteine in coronary artery disease. Clin Chem., 47(5), 887–892.
Perna, A. F., Ingrosso, D., & De Santo, N. G. (2003) Homocysteine and oxidative stress. AminoAcids., 25(3–4), 409–417. doi: 10.1007/s00726-003-0026-8
Satilmis, S., Celik, O., Biyik, I., Ozturk, D., Celik, K., Akın, F., et al. (2015) Association between serum vitamin D levels and sub clinical coronary atheros clerosis and plaque burden/composition in young adult population. Bosn J Basic Med Sci., 15(1), 67–72. doi: 10.17305/bjbms.2015.238.
Downloads
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)
