Document Detail


Association of elevated homocysteine levels with a higher risk of recurrent coronary events and mortality in patients with acute myocardial infarction.
MedLine Citation:
PMID:  12963566     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Despite the prothrombotic and proinflammatory effects associated with elevated homocysteine levels, only limited data exist regarding the effect of homocysteine levels on outcome of patients with acute myocardial infarction. METHODS: Homocysteine levels were determined within 24 hours of presentation in 157 consecutive patients with acute myocardial infarction. Patients were allocated to 2 groups: those with homocysteine levels of 2.7 mg/L (20 micro mol/L) or more (n = 22 [14%]) and those with homocysteine levels of less than 2.7 mg/L (n = 135 [86%]). RESULTS: Female and diabetic patients had significantly lower homocysteine levels than males (P<.01) and nondiabetic patients (P =.005), respectively, with no significant correlation with age (r = 0.07, P =.42) or other risk factors. Patients with homocysteine levels greater than or equal to 2.7 mg/L and less than 2.7 mg/L did not differ significantly regarding extent of coronary artery disease as reflected by prevalence of multivessel disease (54% vs 61%; P =.87), and their in-hospital course. However, in a mean +/-SD follow-up of 30 +/- 10 months, patients with homocysteine levels greater than or equal to 2.7 mg/L had a higher incidence of recurrent coronary events (36% vs 17%; P =.04) and death (18% vs 5%; P<.05). Homocysteine levels greater than or equal to 2.7 mg/L remain a significant determinant of recurrent coronary event and/or death after controlling for potential cofounders by multivariate analysis (odds ratio, 3.8; 95% confidence interval, 1.3-11.0). CONCLUSIONS: In patients with acute myocardial infarction, elevated homocysteine levels are associated with a higher risk of recurrent coronary events and death, independent of other risk factors and the extent of coronary artery disease.
Authors:
Shlomi Matetzky; Dov Freimark; Sela Ben-Ami; Ilan Goldenberg; Jonathan Leor; Ram Doolman; Ilya Novikov; Michael Eldar; Hanoch Hod
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of internal medicine     Volume:  163     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-09-09     Completed Date:  2004-02-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1933-7     Citation Subset:  AIM; IM    
Affiliation:
Heart Institute, Sheba Medical Center, Tel Hashomer, Israel.
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Artery Disease / blood*
Female
Heart Catheterization
Homocysteine / blood*
Humans
Male
Middle Aged
Myocardial Infarction / blood*,  mortality
Prognosis
Prospective Studies
ROC Curve
Recurrence
Risk Factors
Chemical
Reg. No./Substance:
454-28-4/Homocysteine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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