| Coronary artery disease (CAD) is one of the main disease to threaten human's health for the time being. In many countries, especially in the developed countries like America and some west European countries, its morbidity rates and mortality rates are increasing quickly. In our country, coronary artery disease has also been taking on obvious ascending trend and has become the leadind cause of death in many cities and regions. It was already found that many risk factors contributed to the development of coronary artery disease, such as diabetes mellitus, hypertension, hypercholesterolemia, smoking, gender, age and etc. There are quite a number of "normal" persons with coronary artery disease, who are withlow scores of risk factors of CAD . Besides, there are still many difficulties in correcting or killing the risk factors.Recent studies have showed that hyperhomocysteinemia was also closely related with the development of coronary artery disease.There has been a wealth of epidemiological evidence that there areassociation between hyperhomocysteinemia and coronary arterydisease. There were many reports published on these findings during the past years.This study was designed to investigate the levels of plasma homocysteine in patients with CAD and sub-CAD and high risk factors, the relationship between the severity of coronary artery lesion and the level of plasma homocysteine, and the effects of interventional therapy of folic acid on the patients with hyperhomocysteinemia.2. Objective and Methods 2.1 ObjectiveFrom October 2000 to October 2002, a total of 126 patients who underwent coronary angiogram in our hospital was enrolled, male 94 , female 32, age ranged from 38 to 78 years, average age 50.3± 13.6 years. ≥ 60 y/o (72 cases),<60 y/o (54 cases). 58 cases were diagnosed as CAD ,37 cases were sub-CAD and 31 cases were normal. 68 patients were received coronary angiography to exclude CAD(the criterion of CAD is that more than one main vessel has obstruction ≥ 50%). The traditional risk factors include: (1) Diabetes mellitus, (2) Hypertension, (3) hypercholesterolemia, (4) smoking, (5) family history of CAD, (6) age (male >55, female >60), (7) male. 37 patients with more than 3 risk factors above were admitted to high-risk group; 31 patients with 0-2 risk factors were admitted to low-risk group. CAD group was divided into three sub-groups further. Single-vesselgroup(27 cases): significant stenosis in one vessel only. Double-vessel group(20 cases): significant stenosis in two vessels. Triple-vessel group(11 cases): There was stenosis in LAD, LCX and RCA, or LM disease with RCA stenosis.Age, gender, the history of present illness, smoking, hypertension and diabetes mellitus was carefully taken and recorded. Blood tests such as lipid and glucose were ordered. There was no significant difference between the use of anti-anginal agents in all CAD patients before coronary angiogram. Those who ever took any medicine which would interfere the metabolism of plasma Hey such as folic acid and VitB were ruled out.The patients were divided into 3 groups according to the following criteria. CAD group: coronary angiogram showed at least one lesion(stenosis≥50%) in left main(LM), left anterior descending(LAD, including major diagnol), left circumflex(LCX, including major marginal branch) or right coronary(RCA, including posterior descending and posterior left ventricular branch); those who had abnormal renal function or severe peripheral vascular disease were excluded. Sub-CAD group: there was lesions in coronary artery, but the stenosis < 50%. Healthy control: normal coronary angiogram, without X syndrome, spontaneous or variable angina pectoris confirmed by EKG or Treadmill test, or distinct evidence of myocardial infarction (history, EKG and enzyme change).2.2 Methods2.2.1 Coronary angiogram: Judkin's method was routinely adopted with JL3.5-5 and JR3.5-5 coronary angiography catheter via right femoral artery route except that 7 cases of angiogram was done v...
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