| Autor: |
Olsen T; 1 Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway., Vinknes KJ; 1 Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway., Svingen GF; 2 Department of Heart Disease, Haukeland University Hospital, Bergen, Norway., Pedersen ER; 2 Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.; 3 KG Jebsen Centre for Diabetes Research, University of Bergen, Norway., Dhar I; 4 Department of Clinical Science, Faculty of Medicine, University of Bergen, Norway., Tell GS; 5 Department of Global Public Health and Primary Care, University of Bergen, Norway.; 6 Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway., Blomhoff R; 1 Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway.; 7 Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Norway., Ueland PM; 8 Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway.; 9 Bevital AS, Bergen, Norway., Midttun Ø; 9 Bevital AS, Bergen, Norway., Refsum H; 1 Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway., Nygård OK; 2 Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.; 3 KG Jebsen Centre for Diabetes Research, University of Bergen, Norway.; 4 Department of Clinical Science, Faculty of Medicine, University of Bergen, Norway. |
| Abstrakt: |
Background Plasma total homocysteine (tHcy) has been implicated in the development of cardiovascular disease, but the mechanisms remain unclear. Vitamin A (Vit-A) is involved in homocysteine metabolism and we therefore explored the potential interaction between plasma tHcy and serum Vit-A in relation to incident acute myocardial infarction. Methods Cox proportional hazards models were used to assess the prospective relationships between tHcy and acute myocardial infarction in 2205 patients from Western Norway undergoing elective coronary angiography for suspected stable angina pectoris. Results are reported as hazard ratio per standard deviation increase in log-transformed tHcy. An interaction term for tHcy × Vit-A was added to multivariate models including age, sex, smoking, apolipoprotein B fasting, statin and aspirin prescription and estimated glomerular filtration rate. Results Geometric mean (geometric standard deviation) age of the participants (64.3% men) was 62.3 (1.24) years. Plasma tHcy was higher among participants in the upper versus lower Vit-A tertile. During 7 (2.4) years of follow-up, 15.1% suffered an AMI. A significant association of plasma tHcy with AMI in the total study population was observed. When we stratified the population according to Vit-A tertiles, plasma tHcy was associated with acute myocardial infarction only in the upper Vit-A tertile (hazard ratio per SD: 1.25, 95% confidence interval: 1.04-1.53, p interaction = 0.03). Conclusions The risk relationship between plasma tHcy and acute myocardial infarction was modified by serum concentrations of Vit-A in patients with suspected stable angina pectoris. This finding may clarify the relationship between tHcy and cardiovascular disease. |
