Unlabelled: Homocysteine is considered to be a risk factor for the development of cardiovascular disease. Several observations suggest that there might be links between hyperhomocysteinemia and insulin resistance, its clinical surrogate of metabolic syndrome. The aim of the present study is to determine whether the presence of the metabolic syndrome is associated with elevated levels of homocysteine in patients with prior myocardial infarction.

Methods: We studied 104 consecutive patients with prior myocardial infarction undergoing coronary angiography. Patients were divided into two groups according to the presence or absence of metabolic syndrome, as certified by Adult Treatment Panel III. The dosage of homocysteine was measured by high performance liquid chromatography. The relationship between homocysteine levels and metabolic syndrome was assessed by multivariable regressions after adjustment on the basis of recognized predictive factors: age and sex.

Results: Out of a total numbers of patients with myocardial infarction (104; 63.6 +/- 9.2 years of age, 45.1% males) taken in study, 32 (30.1%) had metabolic syndrome. The mean level of homocysteine was significantly higher in the metabolic syndrome group (14.8 micromol/L) than in the free metabolic syndrome group (17.9 micromol/L) (p < or = 0.001). We found a positive correlation between plasma homocysteine levels and metabolic syndrome parameters.

Conclusion: Elevated homocysteine levels were correlated to the metabolic syndrome in patients with prior myocardial infarction. These data indicate that elevated plasma homocysteine levels are not a risk factor for cardiovascular events in metabolic syndrome patients in contrast to patients without the metabolic syndrome.

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