Comparison of plasma homocysteine concentrations (HYC) in patients with acute coronary syndrome (ACS) and newly or previously diagnosed type 2 diabetes
Maria Kurowska1, Jerzy S Tarach1, Wojciech Gernand2, Janusz Kudlicki3, Adam Tarkowski3, Andrzej Nowakowski1, Teresa Czekajska3 & Janusz Solski2
Introduction: The patients with ACS and scheduled for an elective coronary angiography have high frequency of both newly and previously diagnosed diabetes. The diabetic patients with acute myocardial infarction have an increased risk of death. Elevated blood HYC is strongly related to an increased risk for atherosclerosis and cardiovascular disease. This association is particularly evident in patients with diabetes.
Aim of the study: An attempt to evaluate whether cardiovascular risk expressed by serum HYC in ACS patients differs between groups of patients with newly or previously diagnosed type 2 diabetes.
Group of patients: 95 cases (30F and 65M) of which 71 pts (18F; 53M) without previously diagnosed disorders of carbohydrate metabolism and 24 patients (12F and 12M) with previously diagnosed type 2 diabetes. Patients aged 4190 years.
Methods: In all patients the following parameters have been measured: 1 The blood glucose level in the course of acute coronary disorders (admission glucose); 2 Fasting blood glucose in the next day; 3 Serum HYC applying chemiluminescence method (IMMULITE, DTC reagents). Diagnosis of type 2 diabetes has been established according WHO criteria.
Results: Patients with recent diagnosed t. 2 diabetes constituted 13% of group without previously known symptoms of carbohydrate disorders. The mean admission glucose level in the group with newly diagnosed diabetes was 151.8±26.9 mg/dl; in the group with previously known diabetes was 218.8±127.1 mg/dl. Mean HYC in the former group was 18.4±7.3 μmol/l (F-20.2±9.9; M- 17.5±6.6 μmol/l) and 15.3±5.2 μmol/l (F-15.3±4.9; M-15.4±5.6 μmol/l) in the latter, respectively. In the group with normoglycemia the mean serum HYC were 15.02±5.2 μmol/l (M-15.5±5.5 μmol/l, F-13.6±4.6 μmol/l).
Conclusions: The cardiovascular risk estimated according to serum HYC is higher in ACS patients with newly diagnosed type 2 diabetes.