Document Detail

Plasma homocysteine level and left ventricular thrombus formation in acute anterior myocardial infarction patients following thrombolytic therapy with t-PA.
MedLine Citation:
PMID:  19136146     Owner:  NLM     Status:  MEDLINE    
AIMS: The aim of this study was to evaluate the relationship between homocysteine levels and the development of left ventricular thrombus in acute anterior myocardial infarction patients directed to thrombolytic therapy. METHODS AND RESULTS: Seventy-nine patients presenting with ST elevated acute anterior myocardial infarction and treated with thrombolytic agent, t-PA, were included in the study. Two-dimensional echocardiography was used to divide patients into 2 groups according to the presence (n = 14) or absence (n = 65) of thrombus in the left ventricle following myocardial infarction. The levels of fasting plasma total homocysteine, total cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, vitamin B12 and folic acid were assessed. There were no significant differences between two groups in terms of age, gender, hyperlipidemia and smoking. History of diabetes mellitus (28.57% versus 6.15%, p = 0.04), peak creatine phosphokinase levels (4153.54 +/- 1228.41 U/L versus 2456.92 +/- 1421.36 U/L, p < 0.001), mean left ventricular wall motion score index (2.21 +/- 0.18 versus 1.83 +/- 0.23, p < 0.001) and total fasting homocysteine levels (18.24 +/- 5.67 mmol/L versus 12.31 +/- 3.52 mmol/L, p < 0.001) were significantly higher in patients with left ventricular thrombus. In multivariate analysis; only diabetes mellitus (p = 0.03), higher wall motion score index (p = 0.001) and higher homocysteine levels (p = 0.04) were independent predictors of left ventricular thrombus formation. CONCLUSION: Our results suggest that; diabetes mellitus, higher wall motion score index and hyperhomocysteinemia independently increases the risk for the development of left ventricular thrombus formation in patients with acute anterior myocardial infarction following thrombolytic therapy.
Ahmet L Orhan; Ertugrul Okuyan; Baris Okcun; Zekeriya Nurkalem; Nurten Sayar; Ozer Soylu; Nevzat Uslu; Ahmet Yildiz; Mehmet Eren; Hasim Mutlu; Serdar Kucukoglu
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Publication Detail:
Type:  Journal Article     Date:  2009-01-10
Journal Detail:
Title:  Thrombosis research     Volume:  124     ISSN:  1879-2472     ISO Abbreviation:  Thromb. Res.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-24     Completed Date:  2009-10-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0326377     Medline TA:  Thromb Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  65-9     Citation Subset:  IM    
Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Cardiology Department, Istanbul, Turkey.
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MeSH Terms
Echocardiography / adverse effects,  methods
Fibrinolytic Agents / therapeutic use
Heart Ventricles / physiopathology*,  ultrasonography
Homocysteine / blood*
Middle Aged
Myocardial Infarction / drug therapy,  physiopathology*,  ultrasonography
Thrombolytic Therapy
Thrombosis / blood*,  drug therapy,  ultrasonography
Tissue Plasminogen Activator / therapeutic use
Ventricular Dysfunction, Left / blood*,  ultrasonography
Reg. No./Substance:
0/Fibrinolytic Agents; 454-28-4/Homocysteine; EC Plasminogen Activator

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