Serum homocysteine, creatinine, and glucose as predictors of the severity and extent of coronary artery disease in asymptomatic members of high-risk families

• Published in: European journal of clinical investigation Vol. 32; no. 7; pp. 472 - 478
• Main Authors: Pajunen, P., Syvänne, M., Nieminen, M. S., Kareinen, A., Viitanen, L., Lehto, S., Laakso, M.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.07.2002; Blackwell
• Subjects: Biological and medical sciences; Biomarkers - blood; Blood Glucose - analysis; Cardiology. Vascular system; Coronary Angiography; coronary disease; Coronary Disease - blood; Coronary Disease - diagnosis; Coronary Disease - etiology; Coronary heart disease; Creatinine - blood; Diabetes Complications; diabetes mellitus; Diabetes Mellitus - blood; Diagnosis, Computer-Assisted; family history; Female; Genetic Predisposition to Disease; Heart; homocysteine; Homocysteine - blood; Humans; Logistic Models; Male; Medical sciences; Middle Aged; Predictive Value of Tests; Risk Factors; Endocrinopathy; Creatinine; Human; High risk; Thiol; Urinary system disease; Diabetes mellitus; Biological marker; Cardiovascular disease; Coronary heart disease; Statistical study; Sulfur containing aminoacid; Homocystein; Severity score; Proteinuria
• ISSN: 0014-2972; 1365-2362
• DOI: 10.1046/j.1365-2362.2002.01019.x

Background There has been no previous study to determine the severity and extent of coronary artery disease (CAD) in subjects with no diagnosis or symptoms of CAD at the time of the angiography. Methods Fifty‐three subjects, who were siblings of patients with early onset CAD, underwent coronary angiography. Indices to describe per‐patient characteristics of CAD were calculated, based on computer‐aided quantitative coronary angiography. Clinical and laboratory characteristics were correlated to the angiographic parameters. Results Serum total homocysteine (ρ = 0·29, P < 0·05) and creatinine (ρ = 0·47, P = 0·001) levels were related to the global atheroma burden index. The median of the atheroma burden index was two times higher in the top homocysteine quartile compared to the lowest quartile. The overall atheroma burden index correlated significantly with the fasting blood glucose level in all subjects. Diabetes, especially when albuminuria was present, was a powerful risk factor. In a multivariate analysis, only age and sex were independent predictors of atheroma burden. Conclusions Serum homocysteine and creatinine concentrations, and diabetes with albuminuria were found to be markers of the severity and extent of CAD in subjects of high‐risk families without symptoms of CAD.