| Association Between
Serum Homocy-Steine, Vitamin B12 |
| Mahidol University
Annual Research Abstracts     Â
Mahidol University Annual Research Abstracts, Vol.28, 2001 83
 were positive for IgG and 6 (10.3%) cases were positive
for IgA. Among 187 healthy controls, 111 (59.4%) cases were
positive for IgG and 83 (44.4%) were positive for IgA. When
C. pneumoniae IgG antibodies were considered, there was significant
difference between CAD patients and healthy controls (OR = 1.91,
95% CI 1.272.88, p = 0.0018). In cases of positive IgA antibodies,
significant difference was also found between CAD patients and
healthy controls (OR = 1.49, 95% CI = 1.02 2.19, p = 0.0257).
These findings were also found with higher odds ratio when we
compared between CAD patients and normal coronary angiogram
patients. The result suggested that C. pneumoniae infection
is common in Thai people and chronic C. pneumoniae infection
is more common in CAD patients. Chronic C. pneumoniae infection
may be associated with the development of atherosclerotic coronary
disease and treatement with antibiotics should be considered
in ischemic heart disease. (J Med Assoc Thai 2000; 83: 1054-1058.)
  ASSOCIATION BETWEEN SERUM HOMOCY-STEINE, VITAMIN
B12, FOLATE Â AND THAI CORONARY ARTERY DISEASE PATIENTS
(NO. 207) Â Wattana Leowattana1, Nithi Mahanonda2, Kiertijai
Bhuripunyo2, Sasikant Pokum1 1Department of Clinical Pathology,
2 Her Majestys Cardiac Center, Faculty of Medicine, Siriraj
Hospital, Mahidol University, Bangkok 10700, Thailand. Key words
: Homocysteine, B12, Folate, CAD Patients                     Background
: Homocysteine is an intermediate compound formed during metabolism
of methionine. The plasma level of homocysteine is dependent
on the genetically regulated level of essential enzymes and
the intake of folic acid, vitamin B6 (pyridoxine), and vitamin
B12 (cobalamine). Elevated serum homocysteine levels are a known
risk factor for coronary artery disease (CAD). To establish
the magnitude of the CAD that is associated with an increased
serum homocysteine level, we compared CAD patients with normal
healthy Thai controls. Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Method
: In a cross-sectional study design we investigated the association
between serum homocysteine, vitamin B12 and folate levels and
the coronary heart disease in 178 CAD patients and 178 normal
healthy controls by age and sex matching. These comprised 266
men and 90 women, mean age 5810 years for normal controls and
6010 years for CAD patients. Serum homocysteine, vitamin B12
and folate were measured by ELISA method and electrochemiluminescense
method respectively. Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Results:
Paired t-test analysis showed that serum homocysteine concentrations
were significantly higher in CAD patients (23.8311.29 mmol/L)
than in control subjects (19.698.51 mmol/L; p                     Conclusions
: Serum homocysteine concentrations were significantly higher
in CAD patients than in controls. Serum vitamin B12 and serum
folate levels were not statistically significantly different
between CAD patients and control groups. The data also demonstrated
that the serum homocysteine level is almost always higher in
men than in women as previously reported. Although serum vitamin
B12 and serum folate levels were not below the upper limit of
normal, vitamin B12 and folic acid treatment may reduce serum
homocysteine concentrations in CAD patients. We hope that the
reversible risk factors will be concern to clinicians for the
reduction in the risk of myocardial infarction. (J Med Assoc
Thai 2000; 83: 536-542.) Â Â SERUM CARDIAC TROPONIN
T IN UNSTABLE ANGINAPECTORIS PATIENTS Â (NO. 208) Â
Wattana Leowattana1 , Nithi Mahanonda2, Kiertijai Bhuripanyo2,
Sasikant Pokum1, Sudcharee Kiartivich1 1Department of Clinical
Pathology, 2Her Majestys Cardiac Center, Faculty of Medicine,
Siriraj Hospital, Mahidol University, Bangkok10700, Thailand.
Key words : Troponin T, Unstable Angina                     Cardiac
troponin T (cTnT) is a regulatory contractile protein not normally
found in blood. Its detection in the circulation has been shown
to be a sensitive and specific marker for myocardial cell damage.
In this study, we used a second-generation enzyme immunoassay
for cTnT to determine whether its presence in the serum of patients
with unstable angina was a prognostic indicator. Thirty patients
with unstable angina pectoris (UAP) and 30 patients with Q-wave
acute myocardial infarction (AMI) were screened for serum CK-MB
activity and cTnT at 6, 12, 24 and 48 hours after the onset
of chest pain, All of the mean concentrations of CK-MB activity
determined in UAP patients were less than the upper limit of
normal (25 U/L). Meanwhile, the mean concentration of cTnT at
6, 12, 24 and 48 hours after onset of chest pain were higher
than the cutoff values (0.1 m/L), We found that one third of
UAP patients had serum cTnT at the time of admission more than
0.1 m/L and that these groups of patients were associated with
a high risk for cardiac events. Our results suggested that patients
with elevated serum cTnT could be considered as high-risk patients
for developing myocardial infarction, Patients with normal cTnT
levels and a low or intermediate clinical risk could be stabilized
and further stratified noninvasively. (J Med Assoc Thai 2000
Nov; 83 Suppl 2:S61-5.) Â Â CORRELATION OF SERUM
LIPOPROTEIN (A) WITH THE CLINICAL Â PRESENTATION OF THAI
CORONARY ARTERY DISEASE PATIENTS (NO. 209) Â Wattana Leowattana1,
Nithi Mahanonda2, Kiertijai Bhuripanyo2, Sasikant Pokum1 , Pattama
Worawattananon1 1Department of Clinical Pathology, 2Her Majestys
Cardiac Center, Faculty of Medicine, Siriraj Hospital, Mahidol
University, Bangkok 10700, Thailand. Key words : Serum Lp(a),
CAD, Thailand   |
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