Copyright © 2002 by the European Society of Cardiology.
Association of plasma homocysteine with restenosis after percutaneous coronary angioplasty
Division of Cardiology, Swiss Cardiovascular Center Bern, University Hospital, Bern, Switzerland
revised August 13, 2001; accepted August 15, 2001
Abstract
Aims Restenosis after percutaneous coronary angioplasty remains an important limitation of this procedure. This study evaluates whether elevated total plasma homocysteine levels contribute to the development of restenosis after coronary angioplasty.
Methods and Results Two hundred and five patients were recruited after successful angioplasty of at least one coronary stenosis (
50%). End-points were restenosis (50%) and a composite of major adverse cardiac events. Of the 205 patients, 183 (89·3%) underwent 6 months angiographic follow-up. Patients with restenosis had significantly higher homocysteine levels than those without (10·9± 3·9µmol.l–1 vs 9·3±3·8µmol.l–1, P<0·01). Homocysteine levels were significantly correlated to follow-up diameter stenosis (r=0·24, P=0·0001), especially in small vessels (<3mm) treated with balloon angioplasty only (r=0·40,P <0·0005). Late lumen loss at follow-up was significantly smaller with homocysteine levels below 9µmol.l–1 (0·62±0·82mm vs 0·90±0·77mm, P<0·01). Restenosis rate (25·3% vs 50·0%,P <0·001) and major adverse cardiac events (15·7% vs 28·4%,P <0·05) were also significantly lower in patients with homocysteine levels below 9µmol.l–1. Multivariate analysis did not weaken these findings.
Conclusion Total plasma homocysteine is a strong predictor of restenosis and major adverse cardiac events after coronary angioplasty. Thus, plasma homocysteine appears to be an important cardiovascular risk factor influencing outcome after successful coronary angioplasty.
Key Words: Angioplasty, death, homocysteine, myocardial infarction, restenosis
f1 Correspondence: Guido Schnyder, MD, UCSD Medical Center-MC 8784, Cardiology Division, 200 West Arbor Drive, San Diego, CA 92103, U.S.A.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  R Marcucci, D Brogi, F Sofi, C Giglioli, S Valente, A Alessandrello Liotta, M Lenti, A M Gori, D Prisco, R Abbate, et al. PAI-1 and homocysteine, but not lipoprotein (a) and thrombophilic polymorphisms, are independently associated with the occurrence of major adverse cardiac events after successful coronary stenting Heart, March 1, 2006; 92(3): 377 - 381. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Brasselet, R. Garnotel, A. Lafont, S. Perotin, F. Vitry, E. Durand, L. Ducher, J. Elaerts, D. Metz, and P. Gillery Prepercutaneous Coronary Intervention Plasma Homocysteine Concentration Is a Useful Predictor of Angioplasty-Induced Myocardial Damage Clin. Chem., December 1, 2005; 51(12): 2374 - 2377. [Full Text] [PDF]
|
|
|
|
 |
|
 G. De Luca, H. Suryapranata, G. Gregorio, H. Lange, and M. Chiariello Homocysteine and Its Effects on In-Stent Restenosis Circulation, November 8, 2005; 112(19): e307 - e311. [Full Text] [PDF]
|
|
|
|
|
|
C-K Wong, C J K Hammett, R The, J K French, W Gao, B J Webber, J M Elliott, A W Hamer, J A Ormiston, M W I Webster, et al. Lack of association between baseline plasma homocysteine concentrations and restenosis rates after a first elective percutaneous coronary intervention without stenting Heart, November 1, 2004; 90(11): 1299 - 1302. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Lange, H. Suryapranata, G. De Luca, C. Borner, J. Dille, K. Kallmayer, M. N. Pasalary, E. Scherer, and J.-H. E. Dambrink Folate Therapy and In-Stent Restenosis after Coronary Stenting N. Engl. J. Med., June 24, 2004; 350(26): 2673 - 2681. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Koch, G. Ndrepepa, J. Mehilli, S. Braun, M. Burghartz, H. Lengnick, K. Kolling, A. Schomig, and A. Kastrati Homocysteine Status and Polymorphisms of Methylenetetrahydrofolate Reductase Are Not Associated With Restenosis After Stenting in Coronary Arteries Arterioscler. Thromb. Vasc. Biol., December 1, 2003; 23(12): 2229 - 2234. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T.-M. Lu, Y.-A. Ding, S.-J. Lin, W.-S. Lee, and H.-C. Tai Plasma levels of asymmetrical dimethylarginine and adverse cardiovascular events after percutaneous coronary intervention Eur. Heart J., November 1, 2003; 24(21): 1912 - 1919. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Matetzky, D. Freimark, S. Ben-Ami, I. Goldenberg, J. Leor, R. Doolman, I. Novikov, M. Eldar, and H. Hod Association of Elevated Homocysteine Levels With a Higher Risk of Recurrent Coronary Events and Mortality in Patients With Acute Myocardial Infarction Arch Intern Med, September 8, 2003; 163(16): 1933 - 1937. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Schnyder, Y. Flammer, M. Roffi, R. Pin, and O. M. Hess Plasma homocysteine levels and late outcome after coronary angioplasty J. Am. Coll. Cardiol., November 20, 2002; 40(10): 1769 - 1776. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Schnyder, M. Roffi, Y. Flammer, R. Pin, and O. M. Hess Effect of Homocysteine-Lowering Therapy With Folic Acid, Vitamin B12, and Vitamin B6 on Clinical Outcome After Percutaneous Coronary Intervention: The Swiss Heart Study: A Randomized Controlled Trial JAMA, August 28, 2002; 288(8): 973 - 979. [Abstract] [Full Text] [PDF]
|
|