Document Detail


Association of plasma homocysteine with restenosis after percutaneous coronary angioplasty.
MedLine Citation:
PMID:  11977999     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Restenosis after percutaneous coronary angioplasty remains an important limitation of this procedure. This study evaluates whether elevated total plasma homocysteine levels contribute to the development of restenosis after coronary angioplasty. METHODS AND RESULTS: Two hundred and five patients were recruited after successful angioplasty of at least one coronary stenosis (> or =50%). End-points were restenosis (> or =50%) and a composite of major adverse cardiac events. Of the 205 patients, 183 (89.3%) underwent 6 months angiographic follow-up. Patients with restenosis had significantly higher homocysteine levels than those without (10.9+/- 3.9 micromol x l(-1) vs 9.3+/-3.8 micromol x l(-1), P<0.01). Homocysteine levels were significantly correlated to follow-up diameter stenosis (r=0.24, P=0.0001), especially in small vessels (<3 mm) treated with balloon angioplasty only (r=0.40, P<0.0005). Late lumen loss at follow-up was significantly smaller with homocysteine levels below 9 micromol x l(-1) (0.62+/-0.82 mm vs 0.90+/-0.77 mm, P<0.01). Restenosis rate (25.3% vs 50.0%, P<0.001) and major adverse cardiac events (15.7% vs 28.4%, P<0.05) were also significantly lower in patients with homocysteine levels below 9 micromol x l(-1). Multivariate analysis did not weaken these findings. CONCLUSION: Total plasma homocysteine is a strong predictor of restenosis and major adverse cardiac events after coronary angioplasty. Thus, plasma homocysteine appears to be an important cardiovascular risk factor influencing outcome after successful coronary angioplasty.
Authors:
G Schnyder; M Roffi; Y Flammer; R Pin; O M Hess
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European heart journal     Volume:  23     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-04-29     Completed Date:  2002-07-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  726-33     Citation Subset:  IM    
Copyright Information:
Copyright 2001 The European Society of Cardiology.
Affiliation:
Division of Cardiology, Swiss Cardiovascular Center Bern, University Hospital, Bern, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects*
Biological Markers / blood
Coronary Angiography
Coronary Restenosis / blood*,  etiology*,  mortality
Coronary Stenosis / complications,  radiography,  therapy
Coronary Vessels / surgery
Endpoint Determination
Female
Follow-Up Studies
Homocysteine / blood*
Humans
Incidence
Male
Middle Aged
Postoperative Complications / blood,  etiology,  mortality
Prospective Studies
Recurrence
Severity of Illness Index
Statistics as Topic
Survival Analysis
Treatment Outcome
Chemical
Reg. No./Substance:
0/Biological Markers; 454-28-4/Homocysteine

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