Conditional risk factors in men with previous myocardial infarction: relevance of C3 and homocysteine

• Published in: Acta Cardiologica 2001-10, Vol.56 (5), p.303-311
• Main Authors: Muscari, Antonio, Mele, Maria C., Bastagli, Luciana, Poggiopollini, Guido, Tomassetti, Vincenzo, Drago, Gianmarco, Legnani, Cristina, Barini, Angela, Cappelletti, Onda, Boni, Paola, Puddu, Paolo
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; C-reactive protein; Cardiology. Vascular system; Case-Control Studies; Complement C3 - metabolism; complement-3; Coronary heart disease; fibrinogen; Heart; homocysteine; Homocysteine - blood; Humans; Medical sciences; Middle Aged; Myocardial Infarction - blood; Myocardial Infarction - etiology; plasminogen activator inhibitor-1; previous myocardial infarction; Risk Factors; Statistics, Nonparametric
• ISSN: 0001-5385; 1784-973X
• DOI: 10.2143/AC.56.5.2005691

Objective -To establish which traditional and conditional risk factors were effectively treated, and which remained active, in patients with previous myocardial infarction (PMI). Methods and results - In 47 PMI patients recently submitted to cardiological assessment and in 42 controls (50-70 years old men), traditional risk factors (total cholesterol, high-density lipoprotein cholesterol, blood glucose, blood pressure, cigarette smoking and body mass index) and the following variables were measured: fibrinogen, plasminogen activator inhibitor-1 (PAI-1), lipoprotein(a) [Lp(a)], total homocysteine, plasma folates, vitamin B12, high sensitivity C-reactive protein and C3 complement. Most patients were taking beta-blockers, ACE inhibitors and statins. Accordingly, patients had lower blood pressure and cholesterol values than controls. Moreover, they consumed less alcohol and coffee and did not differ from controls in cigarette smoking and body mass index. Conversely, patients had higher levels of homocysteine, fibrinogen, C3 complement and Lp(a), although of these factors only C3 and homocysteine remained significantly associated with PMI in multivariate analysis. C-reactive protein, PAI-1 and especially C3 often correlated with traditional risk factors in controls, but these correlations tended to disappear or reverse in PMI patients. Fibrinogen inversely correlated with alcohol consumption. Homocysteine correlated (inversely) with plasma folates only. Lp(a) did not correlate with any variable. Conclusions - Forty-seven patients with previous myocardial infarction displayed an excellent control of traditional risk factors, but they had higher mean C3 and homocysteine levels than the control group.