Homocysteine and major coronary events: a prospective population study amongst women

Knekt P, Alfthan G, Aromaa A, Heliövaara M, Marniemi J, Rissanen H, Reunanen A (National Public Health Institute, Helsinki, and Social Insurance Institution, Turku, Finland). Homocysteine and major coronary events; a prospective population study amongst women. J Intern Med 2001; 249: 461–465. Objectives. To study serum homocysteine concentration for its prediction of major coronary heart disease events amongst women. Design. A case‐control study nested within a follow‐up study. Subjects. A total of 74 and 75 major coronary events (coronary deaths or nonfatal myocardial infarction) which occurred in women with and without known heart disease, respectively, during a 13‐year follow‐up and two individually matched controls per case. Main outcome measure. Major coronary event. Results. Amongst women with baseline heart disease, the relative risk (95% CI) of such events, adjusted for age, smoking, hypertension, diabetes, serum cholesterol and body mass index, was 3.32 (1.05–10.5) in the highest homocysteine quintile compared with the lowest quintile. Amongst women free of heart disease at baseline, the corresponding relative risk value was 0.77 (0.24–2.45). Conclusions. This prospective study support the hypothesis that homocysteine is a risk factor for coronary events in women with heart disease.