Plasma homocysteine is associated with ischemic findings without organic stenosis in patients with slow coronary flow

AimTo investigate the plasma concentrations of homocysteine (Hcy) in slow coronary flow (SCF) patients before and at the end of the exercise test and compare with the values of healthy controls.MethodsStudy population consisted of 41 patients with SCF [68% men, aged 49 ± 8 years], and 41 subjects with normal epicardial coronary arteries [56% men, aged 50 ± 9 years]. Exercise test was performed in all study participants. Blood samples were drawn at rest and immediately at the end of exercise testing after 12 h of overnight fasting.ResultsThe baseline Hcy value of the SCF patients was higher than that of the control subjects (p < 0.0001), and this difference continued after exercise test between the groups (p < 0.0001). Median post-exercise increases in Hcy levels were higher in the SCF group than in the control group, without a significant difference (p = 0.088). In the SCF group after exercise, Hcy levels in 17 patients with angina and 18 patients with ST depression were higher than those without angina and ST depression (p < 0.0001 and p < 0.0001, respectively). In addition, Hcy values in patients with both angina and ST depression were greater than those with either angina (p < 0.05) or ST depression (p < 0.05).ConclusionThe results of this study show that there is an important pathophysiologic link between the increased levels of plasma Hcy, the degree of ischemic findings, and the severity of slow flow in SCF patients.