Document Detail

Homocysteine and short-term risk of myocardial infarction and stroke in the elderly: the Rotterdam Study.
MedLine Citation:
PMID:  9892328     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Elevated homocysteine level increases vascular disease risk. Most data are based on subjects younger than 60 years; data for the elderly are more limited. We examined the relationship of homocysteine level to incident myocardial infarction and stroke among older subjects in a nested case-control study. METHODS: Subjects were participants in the Rotterdam Study, a cohort study among 7983 subjects residing in the Ommoord district of Rotterdam, the Netherlands. Baseline examinations were performed from March 1, 1990, to July 31, 1993. The analysis is restricted to myocardial infarction and stroke that occurred before December 31, 1994. One hundred four patients with a myocardial infarction and 120 with a stroke were identified with complete data. Control subjects consisted of a sample of 533 subjects drawn from the study base, free of myocardial infarction and stroke. Nonfasting total homocysteine levels were measured. RESULTS: Results were adjusted for age and sex. The risk of stroke and myocardial infarction increased directly with total homocysteine. The linear coefficient suggested a risk increase by 6% to 7% for every 1-micromol/L increase in total homocysteine. The risk by quintiles of total homocysteine level was significantly increased only in the group with levels above 18.6 micromol/L (upper quintile): odds ratios were 2.43 (95% confidence interval, 1.11-5.35) for myocardial infarction and 2.53 (95% confidence interval, 1.19-5.35) for stroke. Associations were more pronounced among those with hypertension. CONCLUSIONS: The present study, based on a relatively short follow-up period, provides evidence that among elderly subjects an elevated homocysteine level is associated with an increased risk of cardiovascular disease.
M L Bots; L J Launer; J Lindemans; A W Hoes; A Hofman; J C Witteman; P J Koudstaal; D E Grobbee
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of internal medicine     Volume:  159     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  1999 Jan 
Date Detail:
Created Date:  1999-02-04     Completed Date:  1999-02-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  38-44     Citation Subset:  AIM; IM    
Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands.
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MeSH Terms
Aged, 80 and over
Case-Control Studies
Cerebrovascular Disorders / blood,  epidemiology*
Cohort Studies
Homocysteine / blood*
Myocardial Infarction / blood,  epidemiology*
Netherlands / epidemiology
Odds Ratio
Risk Factors
Reg. No./Substance:

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