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Mild hyperhomocysteinemia is not associated with cardiac allograft coronary disease

N Giannetti1, N A Herity, A Alimollah

  • 1Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA. giannetti@muhc.mcgill.ca

Clinical Transplantation
|October 31, 2001
PubMed

Insights

Mild hyperhomocysteinemia is common in heart transplant recipients but not linked to transplant coronary artery disease. Renal dysfunction and vitamin B6 deficiency may contribute to high homocysteine levels in these patients.

Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Biochemistry

Background:

  • Hyperhomocysteinemia is an independent risk factor for coronary disease.
  • Elevated plasma homocysteine levels are observed in heart transplant recipients.
  • Transplant coronary artery disease is a significant concern in long-term survivors.

Purpose of the Study:

  • To investigate the association between homocysteine levels and transplant coronary artery disease.
  • To determine if elevated homocysteine is present in heart transplant recipients.
  • To explore factors contributing to hyperhomocysteinemia in this population.

Main Methods:

  • Forty-three non-smoking adult heart transplant recipients (2-7 years post-transplant) were studied.
  • Fasting plasma homocysteine levels were measured.
  • Coronary angiography was performed within six months of blood draw to assess for coronary artery disease.

Main Results:

  • The average fasting plasma homocysteine level was 17.0 ± 6.6 micromol/L; 60% of patients had levels >15.0 micromol/L.
  • No significant difference in mean homocysteine levels was found between patients with normal (n=22) and abnormal (n=21) coronary arteries.
  • Homocysteine levels correlated positively with creatinine (r=0.63, p<0.0001) and negatively with vitamin B6 (r=-0.56, p<0.0001).

Conclusions:

  • Mild hyperhomocysteinemia is prevalent in heart transplant recipients.
  • This hyperhomocysteinemia was not associated with transplant coronary artery disease in this cohort.
  • Renal dysfunction and vitamin B6 deficiency may explain the high prevalence of hyperhomocysteinemia.
Abstract

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