Prognostic value of homocysteine and vitamin D for patients with ischemic heart disease and multifocal atherosclerosis

Abstract

Cardiovascular system diseases (CSD) – is one of the most acute medical and social problems of modern society. Ischemic heart disease (IHD) and acute disturbance of cerebral circulation were and remain the leading cause of death and disability. At present, it has been established that in the progression of IHD and its complications, an increase in the level of homocysteine and deficiency of vitamin D are essential. Purpose of the study: to study the effect of hyperhomocysteinemia and deficiency of vitamin D on the course of atherosclerosis and ischemic heart disease. Materials and methods: the study analyzed laboratory data from 58 patients with atherosclerosis. Depending on the prevalence of atherosclerosis patients were divided into 2 groups. All those examined had vitamin D deficiency, as well as hyperhomocysteinemia. These changes were more pronounced in patients with multifocal atherosclerosis, which required a more thorough medication correction after surgical intervention on the coronary and carotid arteries. Results: Of practical interest is the analysis of blood plasma homocysteine concentration values depending on the localization of atherosclerotic lesion. In our study, in the first group, the median plasma homocysteine concentration was significantly higher. Moreover, there was a strong correlation between high concentrations of homocysteine and advanced atherosclerotic lesions. These results may indicate a possible destabilization of atherosclerosis course with hyperhomocysteinemia in combination with vitamin D deficiency. Patients of the first group with multifocal atherosclerosis had significantly higher homocysteine indices and a more pronounced vitamin D deficiency. No less important is the fact that in the examined patients both in one group and in the other group a significant vitamin D deficiency was detected. Conclusions: Hyperhomocysteinemia and vitamin D deficiency – are risk factors for the development of coronary heart disease and are associated with an unfavorable course of coronary pathology. All patients with ischemic heart disease had vitamin D deficiency and hyperhomocysteinemia, more pronounced with multifocal atherosclerosis, which should be considered when prescribing medication after myocardial revascularization.

Keywords

• myocardial ischemia
• homocysteine
• hyperhomocysteinemia
• vitamin D
• dyslipoproteinemia