PLASMA HOMOCYSTEINE, VITAMIN B12, FOLATE (FOLIC ACID) AND PYRIDOXAL PHOSPHATE (PLP) LEVELS IN PATIENTS WITH CORONARY ARTERY DISEASE

ABSTRACT 

Background: Pakistani people have the highest rate of coronary artery disease.  

Aim: To see the correlation between deficiency of vitamins B6, B12, folic acid and hyperhomocysteinemia in  patients with coronary artery disease. 

Settings and duration: The study was carried out at Shaikh Zayed Medical Complex,Lahore. The duration of study was one year.  

Study design: A case-control study. Methodology: Patients with coronary artery disease confirmed on angiography were selected as cases while those without coronary artery disease and having normal carotid doppler study were taken as controls. Fasting venous blood was obtained in EDTA vacutainers. Plasma was analyzed for homocysteine by enzyme immunoassay, vitamin B12 and folic acid was done using competitive protein binding radioassay and vitamin B6 (pyridoxal phosphate, a coenzymic form of vitamin B6) using radioenzymatic assay.  

Results: There were 40 male cases (age 30-45 years) and 40 healthy male controls of same age and socioeconomic status. Mean vitamin B12, B6 and folic acid levels in coronary artery patients were significantly lower than that of the controls, with significant difference in the latter two.  Mean plasma concentration of homocysteine in coronary artery disease cases was higher than that of the controls. Extent of blockage of coronary arteries was directly related to age, with more blockage at advanced ages.  

Conclusions: The nutritional deficiencies through interplay with the classical cardiovascular risk factors may be aggravating the risk of coronary artery disease in Pakistani people.