Effects of Plasma Homocysteine Level and MTHFR Genotype on Presence and Extent of Coronary Artery Disease

The aiın of th is study was ıo deterınine the effects of plasına hoınocyste ine levels and ınethylene tetrahydrofolate reductase (MTHFR) ınutation on the presence and the extent of coronary atherosclerosis. 242 consecutive patients undergoing coronary angiography were prospectively evaluated for conventional risk factors, p lasına h oınocysteine levels, B 12, folate levels and MTHFR genotype. The mean plasma homocysteine levels were 18.5±1 1 pmol/L in 15 1 patients with coronary artery disease and 1 5.6±1 O ı.ııno i/L in 91 patients w ith normal coronary arteries (p>0.05). Plasma homocysteine levels above 15 ı.ınıol/L was a s ignificanı risk factor for coronary artery disease (p=0.03, RR 2. 1, %95 CI 1.07-4.4), and levels above 15 ı.ımol/L were also sign if icantly correlated to the extent of atherosclerosis (p=0.04, RR 3.2 %95 CI 1.3-8.2). The folate levels w ere 7 .0±3.2 ng/nıl in control s and 5.1±1.3 ng/ml in patients with coronary artery disease. When the MTHFR genotype was d e terınined, TT genotype was present in 7.4% of patients and 5.2% of controls (p>0.05). TT genotype was significantly correlated to plasma honıocyste ine levels (p=O.OO 1) and also correlated w ith ıhe extent of coronary atherosclerosis (p=0.03). Our data indicare that a plasma homocysteine level above 15 ~o l/L is a significant risk factor for the presence and extent of coronary artery disease. TT genotype was an important predictor of the homocysteine levels and the extent of coronary atherosclerosis.