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Is Homocysteine an independent risk factor for subclinical coronary atherosclerosis in asymptomatic individuals?
Session:
Sessão de Posters 24 - Biomarcadores em Cardiologia
Speaker:
Gonçalo Bettencourt Abreu
Congress:
CPC 2024
Topic:
J. Preventive Cardiology
Theme:
28. Risk Factors and Prevention
Subtheme:
28.14 Risk Factors and Prevention - Other
Session Type:
Cartazes
FP Number:
---
Authors:
Gonçalo Bettencourt Abreu; Maria Isabel Mendonça; Marco Serrão; Débora Sá; Francisco Sousa; Sónia Freitas; Eva Henriques; Mariana Rodrigues; Sofia Borges; António Drumond Freitas; Ana Célia Sousa; Roberto Palma Dos Reis
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Introduction:</strong> Homocysteine (Hcy) has been known as a risk factor for coronary artery disease (CAD). However, several randomised trials did not demonstrate the clinical benefit of Hcy-lowering therapy in CAD prevention. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Objective:</strong> Evaluate the influence of Hcy on the risk of subclinical coronary atherosclerosis, assessed by coronary artery calcium score (CAC score), in a cohort of asymptomatic individuals.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods:</strong> We evaluated 1,284 asymptomatic individuals with a mean age of 59.3±8.9, 73.6% males, without apparent prior CAD. CAC score was performed by cardiac computed tomography, reported as Agatston units, and stratified in low, moderate and high-risk categories, which assesses the degree and extent of subclinical coronary atherosclerosis. Biochemical analyses were done, and the Hcy levels were stratified into terciles. The bivariate analysis evaluated the association of the Hcy levels with the CAC score categories. After adjusting for confounder variables, a multivariate logistic regression assessed the independent association of the Hcy levels and CAC score. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results:</strong> Bivariate analysis showed that the Hcy levels increased as the percentage of individuals with CAC score severity increased (p=0.002). After an unadjusted logistic regression analysis, Hcy levels (terciles) were significantly associated with CAC score categories (low vs. moderate/high). After adjusting to traditional and clinical risk factors, Hcy did not remain in the equation, not showing an independent association with the CAC score. Only diabetes (OR=2.45; p<0.0001), smoking (OR=1.86; p<0.0001), hypertension (OR 1.59; p<0.0001), CAD family history (OR=1.56; p=0.012), dyslipidemia (OR=1.31; p=0.046) and age (OR 1.04; p<0.0001) were independently associated with CAC severity.</span></span></p> <p><strong><span style="font-size:11.0pt"><span style="font-family:"Calibri",sans-serif">Conclusions:</span></span></strong><span style="font-size:11.0pt"><span style="font-family:"Calibri",sans-serif"> Homocysteine levels were not an independent risk factor for subclinical coronary atherosclerosis (represented by CAC score) in the asymptomatic population. Modifying lifestyle and reducing traditional CV risk factors may be more significant to prevent future CV events</span></span></p>
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