Serum homocysteine does not associate with uncomplicated coronary heart disease

Background Elevated serum homocysteine concentrations have been related to coronary heart disease. However, the association has not indisputably been proven, and the mechanisms by which homocysteine may be atherogenic have only partially been elucidated. The objective of the present study was to investigate whether serum homocysteine is associated with angina pectoris and myocardial infarction. Methods We compared serum homocysteine concentrations in subjects with clinical evidence of angina pectoris or history of myocardial infarction to age-matched controls. The study included 248 males, who participated in a large cross-sectional risk factor survey carried out in five geographic areas in Finland. Results Serum homocysteine concentration was significantly higher in subjects with a history of myocardial infarction compared to controls (15·3 μmol L−1 and 13·9 μmol L−1 respectively, P = 0·037). In a logistic regression model including several cardiovascular risk factors, serum homocysteine was significantly associated with myocardial infarction (95% CI 1·0157–1·2990, P = 0·027). Serum homocysteine concentrations did not differ between subjects with angina pectoris and age-matched controls (13·9 μmol L−1 and 14·2 μmol L−1 respectively). Conclusions Our results suggest that elevated serum homocysteine is associated with myocardial infarction but not with uncomplicated coronary heart disease.