Abstract 21277: Homocysteine and Cardiovascular Risk in Low Risk Healthy Adults - An Analysis of National Health and Nutrition Examination Survey -3
Background: Homocysteine as a risk predictor of cardiovascular events has never been scrutinized systematically for its ability to reclassify individuals in various categories of 10- year estimated risk of hard coronary heart disease (CHD) (e. g. myocardial infarction (MI) and death due to MI). In this study, we assessed whether homocysteine reclassifies individuals in a population of healthy nationally representative adults free of pre-existing cardiovascular disease (CVD) or Diabetes Mellitus (DM).
Methods: The study cohort included 6,206 adults enrolled as a part of the National Health and Nutrition Examination Survey (NHANES) III. Multivariate Cox proportional Hazard analysis was performed to evaluate homocysteine as a predictor of cardiovascular death events. After recalibrating the follow-up to 10 years, discrimination of events using traditional cardiovascular risk factors (CVRF) (age, sex, systolic blood pressure, blood pressure medication use, high density lipoprotein, total cholesterol and smoking) with and without homocysteine was assessed using c-statistics, receiving operating curve characteristics and likelihood ratio test.. Net Reclassification Improvement (NRI) index was calculated by comparing regression models incorporating traditional CVRF with and without homocysteine.
Results: Table 1A and 1B Conclusion: Homocysteine significantly improves risk prediction of cardiovascular events in healthy adults. Furthermore, addition of homocysteine to traditional cardiovascular risk factors significantly reclassifies individuals at intermediate risk for hard CHD events.
- © 2010 by American Heart Association, Inc.