Association of Homocysteine Levels to Traditional Risk Factors in Unstable Angina and Non-ST Elevation Myocardial Infarction: Implications from the FINEST study

Background: Increased blood homocysteine level is a risk factor for unstable angina and non-ST elevation myocardial infarction (NSTEMI).

Studies associate homocysteine levels with conventional cardiovascular risk factors - smoking, diabetes, hypertension, advanced age,

and dyslipidemia – in subjects with evidence of having coronary artery disease.

Objective: This study seeks to determine the effect of conventional cardiovascular risk factors on homocysteine levels of patients with

intermediate to high-risk unstable angina and non ST elevation myocardial infarction (NSTEMI).

Results: Data were taken from 219 patients with unstable angina and non ST elevation myocardial infarction (NSTEMI) with onset within

the past two weeks and who were included in a folic acid supplementation trial (ISRCTN30249553). Using univariate analysis, baseline

homocysteine levels are positively correlated with age (p=0.008) and significant smoking history, both current and past (p=0.028), but

negatively correlated with body mass index (BMI) (p=<0.001). No significant association was detected with diabetes mellitus, hypertension,

dyslipidemia and sex.

Conclusion: Homocysteine levels increase with age and smoking, but decrease with BMI, in patients with unstable angina and NSTEMI.