Association between increased serum neopterin and homocysteine concentrations as well as pyridoxal-5-phosphate deficiency in patients with coronary heart disease

Concentrations of serum neopterin and homocysteine concentrations as well as pyridoxal-5-phosphate (P-5-P) deficiency have been determined in 30 healthy individuals and 61 patients with coronary heart disease (CHD) verified by coronary angiography. Patients have been observed before percutaneus transluminal coronary angioplasty followed by balloon angioplasty (10 patients; group I), 1st time stent implantation (27 patients; group II), repeated stent implantation (8 patients; group III) and due to restenosis (16 patients; group IV). An increase of serum homocysteine concentrations as well as P-5-P deficiency was observed in all groups of CHD patients, while elevated serum neopterin concentrations were identified only in CHD patients of groups III and IV i.e. mainly in patients presenting with serious coronary events. The grade of P-5-P deficiency and serum homocysteine concentrations was higher in patients with restenosis than in patients before the 1st time stent implantation, suggesting that both, normalization of P-5-P and of serum homocysteine concentrations could be significant in the prevention of CHD as well as in the treatment of CHD patients.