Document Detail

Correlation between total homocysteine and cyclosporine concentrations in cardiac transplant recipients.
MedLine Citation:
PMID:  9799758     Owner:  NLM     Status:  MEDLINE    
Increased circulating total homocysteine (tHcy) has been implicated as an independent risk factor for atherosclerotic disease. In cardiac transplant patients, accelerated coronary atherosclerosis is an important cause of late allograft failure; however, studies of tHcy in this at-risk group are limited. We sampled a cohort of 72 subjects 3.95+/-3.14 (mean +/- SD) years after transplantation and found that all had tHcy concentrations above our upper reference limit (15.0 micromol/L). The mean tHcy in the transplant group (25.4+/-7.1 micromol/L) was significantly greater than in our reference group (9.0+/-4.3 micromol/L; n = 457; P <0.001). We also examined the effect of age, gender, time since transplant, serum folate and cobalamin, total protein, urate, creatinine, albumin, and trough whole blood cyclosporine concentrations. In a multiple linear regression model, only creatinine (mean 144+/-52 micromol/L; P = 0.021) and trough cyclosporine concentrations (191+/-163 microg/L; P = 0.015) were independent positive predictors of tHcy, whereas serum folate (8.35+/-7.43 nmol/L; P = 0.018) and time since transplant (P = 0.049) were significant negative predictors. We conclude that hyperhomocysteinemia is a common characteristic of cardiac transplant recipients. Our analysis suggests that folate and renal glomerular dysfunction are important contributory factors; however, whole blood cyclosporine concentrations may also predict the degree of hyperhomocysteinemia in this population and therefore influence interpretation of any apparent response to treatment.
D E Cole; H J Ross; J Evrovski; L J Langman; S E Miner; P A Daly; P Y Wong
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical chemistry     Volume:  44     ISSN:  0009-9147     ISO Abbreviation:  Clin. Chem.     Publication Date:  1998 Nov 
Date Detail:
Created Date:  1998-11-18     Completed Date:  1998-11-18     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9421549     Medline TA:  Clin Chem     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2307-12     Citation Subset:  IM    
Department of Laboratory Medicine & Pathobiology, University of Toronto, Ontario, Canada.
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MeSH Terms
Cyclosporine / blood*,  therapeutic use
Folic Acid / blood
Heart Transplantation*
Homocysteine / blood*
Immunosuppressive Agents / blood*,  therapeutic use
Kidney Glomerulus / physiopathology
Linear Models
Metabolic Diseases / blood*,  drug therapy,  etiology,  physiopathology
Methionine / blood
Middle Aged
Postoperative Complications*
Vitamin B 12 / blood
Reg. No./Substance:
0/Immunosuppressive Agents; 454-28-4/Homocysteine; 59-30-3/Folic Acid; 59865-13-3/Cyclosporine; 63-68-3/Methionine; 68-19-9/Vitamin B 12
Comment In:
Clin Chem. 1998 Nov;44(11):2238-9   [PMID:  9799747 ]

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