(29-10-13) Plasma S-adenosylhomocysteine is associated with the risk of cardiovascular events in patients undergoing coronary angiography

: a cohort study1,2,3
1. Yunjun Xiao,
2. Yuan Zhang,
3. Min Wang,
4. Xinrui Li,
5. Dongfang Su,
6. Jian Qiu,
7. Dan Li,
8. Yan Yang,
9. Min Xia, and
10. Wenhua Ling
+Author Affiliations
1. 1From the Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, China (YX, MW, XL, DS, DL, YY, MX, and WL); the Department of Nutrition and Food Hygiene, Shenzhen Centre for Disease Control and Prevention, Shenzhen, Guangdong, China (YX); and the Department of Cardiology, Guangzhou Military General Hospital, Guangzhou, China (YZ and JQ).
+Author Notes
· ↵2 Supported by a grant from the Key Project of National Natural Science Foundation of China (81130052).
· ↵3 Address reprint requests and correspondence to W Ling, Department of Nutrition, School of Public Health, Sun Yat-sen University, Number 74 Zhongshan Road 2, 510080, Guangzhou, Guangdong, China. E-mail: [email protected].
Abstract
Background: Although cross-sectional studies have shown that plasma S-adenosylhomocysteine (SAH), the metabolic precursor of homocysteine, is associated with cardiovascular disease, the prospective relation between plasma SAH and cardiovascular disease risk is unknown.
Objective: The aim of this study was to prospectively evaluate the association between plasma SAH and cardiovascular disease risk in coronary angiography patients.
Design: Baseline plasma SAH and homocysteine concentrations were measured in 1003 patients aged between 21 and 87 y who underwent coronary angiography. Cox proportional hazards models were used to analyze the association between SAH and homocysteine and the risk of cardiovascular events, including fatal cardiovascular diseases, nonfatal myocardial infarction, and stroke.
Results: During the median follow-up period of 3.0 y, 93 participants developed cardiovascular events (32.7/1000 person-years). The age- and sex-adjusted hazard ratio of cardiovascular events was 3.38 (95% CI: 2.12, 5.39) for each 1-SD increase in the natural log–transformed SAH concentration. The age- and sex-adjusted hazard ratios of cardiovascular events across quartiles of SAH concentrations were 1.0, 2.25, 2.72, and 3.40 (P-trend = 0.007). Further adjustment for other cardiovascular disease risk factors and plasma homocysteine affected the results only slightly. This positive association between SAH and cardiovascular disease risk did not change when participants were stratified by age group, sex, and other baseline covariates. The results among a subset of participants with significant coronary stenosis were similar.
Conclusion: Higher concentrations of plasma SAH are independently associated with an increased risk of cardiovascular events among patients undergoing coronary angiography. This trial was registered at www.chictr.org as ChiCTR-RNRC-08000270.

Source: Am J Clin Nutr November 2013vol. 98 no. 5 1162-1169

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