Association between plasma homocysteine and myocardial SPECT abnormalities in patients referred for suspected myocardial ischaemia

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dc.contributor.author Ankrah, Alfred O.
dc.contributor.author Buscombe, John Richard
dc.contributor.author Sathekge, Mike Machaba
dc.date.accessioned 2012-08-03T11:27:21Z
dc.date.available 2012-08-03T11:27:21Z
dc.date.issued 2012-07
dc.description.abstract BACKGROUND: Elevated plasma homocysteine level has emerged as a relatively newly recognised risk factor for coronary artery disease (CAD). However, reduction of plasma homocysteine levels in large prospective studies did not appear to reduce the risk for subsequent cardiac events. In this study, we investigated the association between plasma homocysteine levels and quantitative indices of myocardial perfusion SPECT imaging in patients referred for myocardial ischaemia. METHODS: Quantitative myocardial perfusion SPECT indices were obtained for 120 patients who were recruited for the study. All patients underwent a two-day rest-stress myocardial perfusion imaging. Plasma venous sampling was done on all patients after an overnight fast. Of the 120 participants (mean age 56 years, 53% males), 33% had elevated plasma homocysteine levels. The plasma homocysteine level was then compared to the results of imaging and other known risk factors. RESULTS: After adjustment for traditional risk factors of coronary artery disease, patients with elevated homocysteine levels had a significantly higher mean summed stress score (SSS) (11.3 vs 6.9, p = 0.02) than patients with a normal homocysteine level. This was true for both single- and multi-vessel disease. Also, patients with elevated homocysteine levels had a higher stress end-systolic volume (SESV) (137 vs 105 ml, p = 0.03) and lower post-stress left ventricular ejection fraction (SEF) (54 vs 64%, p = 0.02). The patients with elevated plasma homocysteine levels also had a significantly lower mean body mass index (BMI) (26.6 vs 30.6 kg/m2, p = 0.002). There was a significant relationship between the total number of known risk factors in a patient with CAD and the proportion of patients presenting with elevated plasma homocysteine levels (p = 0.03). Also, the extent of infarct, as measured by the summed rest score (SRS), was more closely correlated with an elevated homocysteine level than with the degree of ischaemia. CONCLUSION: There was a correlation between plasma homocysteine level and the presence and extent of myocardial perfusion abnormalities in patients with established coronary artery disease, in particular those with multiple risk factors and multi-vessel infarction. en_US
dc.description.uri http://www.cvjsa.co.za en_US
dc.identifier.citation Ankrah, A, Buscombe, J & Sathekge, M 2012, 'Association between plasma homocysteine and myocardial SPECT abnormalities in patients referred for suspected myocardial ischaemia', Cardiovascular Journal of Africa, vol. 23, no. 6, pp. 313-317. en_US
dc.identifier.issn 1995-1892 (print)
dc.identifier.issn 1996-3467 (online)
dc.identifier.other 10.5830/CVJA-2011-048
dc.identifier.uri http://hdl.handle.net/2263/19536
dc.language.iso en en_US
dc.publisher Clinics Cardiv en_US
dc.rights Clinics Cardiv en_US
dc.subject Plasma homocysteine en_US
dc.subject Coronary artery disease en_US
dc.subject Myocardial SPECT indices en_US
dc.subject Myocardial ischaemia en_US
dc.title Association between plasma homocysteine and myocardial SPECT abnormalities in patients referred for suspected myocardial ischaemia en_US
dc.type Article en_US


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