|
|
||||||||||
|
J Am Coll Cardiol, 2002; 40:1769-1776 © 2002 by the American College of Cardiology Foundation |
,*
* Division of Cardiology, Swiss Cardiovascular Center Bern, University Hospital, Bern, Switzerland
Department of Cardiovascular Medicine/F25, The Cleveland Clinic Foundation, Cleveland, Ohio, USA
Division of Cardiology, University of California at San Diego Medical Center, University of California, San Diego, California, USA
Manuscript received March 21, 2002; revised manuscript received June 24, 2002, accepted July 12, 2002.
* Reprint requests and correspondence: Dr. Guido Schnyder, University of California at San Diego Medical Center, Cardiology Division, 200 West Arbor Drive, San Diego, California, 92103-8784, USA.
g.schnyder{at}lycos.com
OBJECTIVES: The aim of this study was to evaluate a possible relationship between homocysteine levels on admission and late outcome after successful percutaneous coronary intervention (PCI).
BACKGROUND: Increasing evidence suggests that mild to moderate elevation of total plasma homocysteine is a graded and potentially modifiable risk factor for cardiovascular disease and death that appears to be largely independent of other traditional risk factors.
METHODS: A total of 549 patients were included after successful PCI of at least one coronary stenosis (
50%). End points were cardiac death, nonfatal myocardial infarction (MI), target lesion revascularization (TLR), and a composite of major adverse cardiac events (MACE). The relationship between homocysteine levels and study endpoints was assessed.
RESULTS: After a median (± SD) follow-up of 58 ± 20 weeks, 6 patients died of cardiac death, 14 were diagnosed with a new MI, and 71 underwent repeat TLR. A graded relationship between homocysteine levels (quartiles) and freedom from MACE was found (p = 0.01). Homocysteine levels (± SD) were associated with cardiac death (14.9 ± 1.7 µmol/l vs. 9.6 ± 4.3 µmol/l, p < 0.005), TLR (10.7 ± 4.4 µmol/l vs. 9.5 ± 4.3 µmol/l, p < 0.05), and overall MACE (11.0 ± 4.4 µmol/l vs. 9.4 ± 4.3 µmol/l, p < 0.005). These findings remained unchanged after adjustment for potential confounders.
CONCLUSIONS: Plasma homocysteine is an independent predictor of mortality, nonfatal MI, TLR, and overall adverse late outcome after successful coronary angioplasty.
| ||||||||||||||||||
This article has been cited by other articles:
![]() |
G. M. Howard-Alpe, J. W. Sear, and P. Foex Methods of detecting atherosclerosis in non-cardiac surgical patients; the role of biochemical markers Br. J. Anaesth., December 1, 2006; 97(6): 758 - 769. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. Brasselet, R. Garnotel, A. Lafont, S. Perotin, F. Vitry, E. Durand, L. Ducher, J. Elaerts, D. Metz, and P. Gillery Prepercutaneous Coronary Intervention Plasma Homocysteine Concentration Is a Useful Predictor of Angioplasty-Induced Myocardial Damage Clin. Chem., December 1, 2005; 51(12): 2374 - 2377. [Full Text] [PDF] |
||||
![]() |
A. von Eckardstein Is there a need for novel cardiovascular risk factors? Nephrol. Dial. Transplant., April 1, 2004; 19(4): 761 - 765. [Full Text] [PDF] |
||||
![]() |
W. Koch, G. Ndrepepa, J. Mehilli, S. Braun, M. Burghartz, H. Lengnick, K. Kolling, A. Schomig, and A. Kastrati Homocysteine Status and Polymorphisms of Methylenetetrahydrofolate Reductase Are Not Associated With Restenosis After Stenting in Coronary Arteries Arterioscler. Thromb. Vasc. Biol., December 1, 2003; 23(12): 2229 - 2234. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Liem, G. H. Reynierse-Buitenwerf, A. H. Zwinderman, J. W. Jukema, and D. J. van Veldhuisen Secondary prevention with folic acid: effects on clinical outcomes J. Am. Coll. Cardiol., June 18, 2003; 41(12): 2105 - 2113. [Abstract] [Full Text] [PDF] |
||||
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |