Objective: To investigate the plasma homocysteine level and the relationship between plasma homocysteine level and duke treadmill score (DTS) in cardiac syndrome X (CSX) patients.

Methods: Seventy-nine patients (36 male, 43 female, mean age: 50 +/- 8.8 years) admitted to Gazi University Hospital, Ankara, Turkey with typical effort angina, positive stress test, and angiographically normal coronary arteries between January and September 2006 were included in this prospective and controlled study. Thirty asymptomatic patients (11 male, 19 female, mean age: 47.6 +/- 8.3 years) with 2 cardiovascular risk factors were chosen as a control group. Plasma homocysteine level was measured in both groups and DTS was calculated in the CSX group. Plasma homocysteine was measured with the AxSYM homocysteine immunoassay method in both groups.

Results: Plasma homocysteine level was higher in the CSX group compared to the control group (16.5 +/- 4.9 micromol/L, n=79, versus 12.4 +/- 4.1 micromol/L, n=30, p<0.001). The DTS was -2.7 +/- 5.3 in the CSX group. There was a negative correlation between the DTS and homocysteine levels in the CSX group. (r= -0.506, p<0.001).

Conclusion: Plasma homocysteine level, which is known to cause endothelial dysfunction and microvascular ischemia were higher in CSX patients. Also, this increase in homocysteine level inversely correlated with the DTS, which represents the magnitude of ischemia.

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