Document Detail

The potential role of homocysteine in percutaneous coronary interventions (PCI): review of current evidence and plausibility of action.
MedLine Citation:
PMID:  15704259     Owner:  NLM     Status:  MEDLINE    
Several millions of patients with coronary heart disease worldwide are treated by means ofpercutaneous interventions each year. Above all conventional balloon dilation and implantation of uncoated stents are, however, only of limited success as reflected by 6-month restenosis rates of 50% (balloon dilation) and 25-35% (bare-metal stent). It is therefore of utmost importance to identify high-risk groups and explore further secondary-prophylactic measures for the prevention of restenosis. A large body of evidence suggests that elevated homocysteine and/or folate and B-vitamin deficiencies are relevant risk factors for restenoses due to their proatherothrombotic potential. Hyperhomocysteinemia is an ideal target as this parameter can be lowered easily, safely and at a low cost by means of folate and B-vitamin supplementation. The results of published studies exploring a potential correlation between homocysteine levels and the risk of restenosis and those of interventional studies for the reduction of the risk of restenosis have not yet lead to consistent conclusions. However, a critical assessment can by no means exclude the plausibility of postinterventional lowering of homocysteine levels. This review aims at providing insight into the current evidence and biological plausibility of homocysteine-lowering therapy in regard to PCI-related vascular damage. Currently available clinical observational and interventional studies are reviewed in detail.
O Stanger
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Cellular and molecular biology (Noisy-le-Grand, France)     Volume:  50     ISSN:  0145-5680     ISO Abbreviation:  Cell. Mol. Biol. (Noisy-le-grand)     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2005-02-10     Completed Date:  2005-07-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9216789     Medline TA:  Cell Mol Biol (Noisy-le-grand)     Country:  France    
Other Details:
Languages:  eng     Pagination:  953-88     Citation Subset:  IM    
Dept of Cardiac Surgery, Cardiovascular Research, St John's Hospital Salzburg, Private Medical University, Müllner Hauptstrasse 48, A-5020 Salzburg, Austria.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary / methods
Clinical Trials as Topic
Coronary Angiography / methods*
Coronary Artery Disease / pathology
Coronary Restenosis / pathology*
Coronary Stenosis / pathology
Endothelium, Vascular / metabolism
Homocysteine / blood,  metabolism,  physiology*
Hyperhomocysteinemia / metabolism
Middle Aged
Models, Biological
Risk Factors
Vitamin B Complex / metabolism
Reg. No./Substance:
12001-76-2/Vitamin B Complex; 454-28-4/Homocysteine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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