| Increased plasma homocysteine concentrations accelerate cardiac allograft vasculopathy. | |
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MedLine Citation:
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PMID: 15539124 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: A toxic and pro-oxidative effect of homocysteine on the coronary endothelium may accelerate cardiac allograft vascular disease (CAVD). In this study, we evaluated the influence of hyperhomocysteinemia on the course of CAVD. METHODS: We investigated plasma homocysteine (tHCY) concentrations in 183 consecutive heart transplant recipients (158 men and 25 women, mean aged 53.1 +/- 10.0 years, at 6.7 +/- 3.2 years after transplantation) to evaluate the course of CAVD. We used serial coronary angiography to assess coronary status and graded the severity of CAVD based on the extent of luminal obstruction in the main coronary arteries (graded as 1-4). We defined progression as increased focal stenosis of >/=30% or as detection of a new coronary lesion after a mean observation period of 2.8 +/- 1.0 years. A multivariate analysis (backward logistic regression) was performed that included potential risk factors for CAVD. We excluded patients undergoing dialysis. RESULTS: Initially, tHCY concentrations were increased in the entire cohort (mean, 18.6 +/- 7.6 mumol/liter) and ranged from 6.6 to 46.9 mumol/liter. A total of 105 patients (57.0%) had CAVD at first angiography, and progression was detected in 52 transplant recipients (28.0%). Patients with progressive CAVD had significantly greater tHCY concentrations (21.6 +/- 6.2 mumol/liter) at baseline investigation compared with patients who had stable courses (17.4 +/- 7.7 mumol/liter; p < 0.001). These results were independent of parameters such as sex, age, dyslipoproteinemia, cyclosporine blood concentrations, and indication for transplantation. CONCLUSIONS: Progression of CAVD is strongly associated with increased tHCY concentrations. The intervals between routine surveillance angiography should be shortened in patients with hyperhomocysteinemia, and routine medical treatment to decrease homocysteine concentrations should be considered. |
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Authors:
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Ingo Kutschka; Klaus Pethig; Wolfgang Harringer; Axel Haverich; Martin Strüber; |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation Volume: 23 ISSN: 1053-2498 ISO Abbreviation: J. Heart Lung Transplant. Publication Date: 2004 Nov |
Date Detail:
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Created Date: 2004-11-12 Completed Date: 2005-07-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9102703 Medline TA: J Heart Lung Transplant Country: United States |
Other Details:
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Languages: eng Pagination: 1260-5 Citation Subset: IM |
Affiliation:
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Department of Thoracic and Cardiovascular Surgery, Klinikum Braunschweig, Hannover, Germany. htg@klinikum-braunschweig.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Coronary Disease
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blood*,
etiology* Disease Progression Female Heart Transplantation / adverse effects* Homocysteine / blood* Humans Male Middle Aged Risk Factors Time Factors |
| Chemical | |
Reg. No./Substance:
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454-28-4/Homocysteine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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