Homocyst(e)inemia in daily practice

We measured plasma levels of homocysl(e)ine in 405 consecutive cases of patients attending an internist's office. The analyses were performed using a high-pressure liquid chromatography apparatus equipped with electrochemical detection. Male and female patients with coronary heart disease had higher levels of plasma homocyst(e)ine than control subjects. About 20% of male coronary patients had levels above the 95th-percentile distribution of the control subjects. Coronary heart disease subjects were older than control subjects; the prevalence of other traditional risk factors for atherosclerosis was similar in patients with and without coronary heart disease, with the exception that affected women had higher levels of plasma uric acid and also showed a higher prevalence of diabetes. Since hyperhomocyst(e)inemia is usually corrected promptly with innocuous therapy, we concluded that elevated homocyst(e)inemia may be an easily reversible risk factor for atherosclerosis.