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Homocysteine and restenosis after percutaneous coronary intervention
N Mahanonda1, W Leowattana, C Kangkagate
1Her Majesty Cardiac Center, Faculty of Medicine, Siriraj Hosptial, Mahidol University, Bangkok, Thailand.
Insights
Elevated homocysteine levels did not correlate with restenosis after percutaneous coronary intervention (PCI). This study found no link between high homocysteine and restenosis risk in patients undergoing PCI.
Area of Science:
- Cardiovascular Medicine
- Clinical Chemistry
Background:
- Elevated homocysteine is linked to increased risk of atherosclerosis and thrombosis.
- Homocysteine may induce vascular cell damage and thrombus formation post-angioplasty.
- The association between homocysteine and restenosis after percutaneous coronary intervention (PCI) requires further investigation.
Purpose of the Study:
- To examine the relationship between plasma homocysteine levels and restenosis after PCI.
- To determine if plasma homocysteine levels can predict restenosis after PCI.
Main Methods:
- One hundred consecutive patients undergoing successful PCI were enrolled.
- Plasma homocysteine levels were measured before PCI.
- Two cut-off points (>= 15 micromol/L and >= 12 micromol/L) were used to define high homocysteine levels.
Main Results:
- No statistically significant correlation was found between plasma homocysteine levels and restenosis after PCI, regardless of the cut-off point used (p>0.05).
- High homocysteine levels (>= 15 micromol/L) were observed in 9 patients with restenosis and 20 without.
- High homocysteine levels (>= 12 micromol/L) were observed in 14 patients with restenosis and 39 without.
Conclusions:
- Plasma homocysteine levels do not appear to be a predictor of restenosis after PCI.
- Further research may be needed to fully elucidate the role of homocysteine in cardiovascular events post-PCI.
Abstract:
Numerous clinical studies in Western and Asian countries suggest that individuals with elevated blood levels of homocysteine have an increased risk of atherosclerosis, myocardial infarction, cerebral infarction, and deep vein thrombosis. Homocysteine is also known to induce both atherogenic and thrombogenic mediators in cultured vascular cells so that homocysteine may influence the damage of endothelial cells, promote smooth muscle cell growth, induce atherogenic mediators and thrombus formation after coronary angioplasty. The association between homocysteine and restenosis after percutaneous coronary intervention (PCI) has been discussed. In this study, the relationship between plasma homocysteine levels and restenosis after PCI to investigate whether plasma homocysteine levels may be a predictor of restenosis after PCI was examined. One hundred consecutive patients who underwent successful PCI were enrolled and plasma homocysteine level was measured in all patients prior to PCI. Plasma for homocysteine level was obtained in 99 of 100 patients who had angioplasty. The mean plasma homocysteine concentration in the enrolled patients was 13.61 +/- 6.04 micromol/L. The minimum and maximum of plasma homocysteine were 4.40 micromol/L and 50.00 micromol/L, respectively. In healthy subjects, the normal reference range of homocysteine level is 5-15 micromol/L However, recent data suggest that some patients may be at increased cardiovascular and cerebrovascular risk at levels as low as 12 micromol/L. For this reason, both cut off points of homocysteine level > or = 15 micromol/L or > or = 12 micromol/L to identify the high homocysteine level group were used. Of 99 patients, high homocysteine level (> or = 15 micromol/L) was established in 9 patients with restenosis versus 20 patients without restenosis. If the cut off point of homocysteine level > or = 12 micromol/L was used, high homocysteine level was established in 14 patients with restenosis versus 39 patients without restenosis. From both cut off points of homocysteine level, there was no correlation between plasma homocysteine level and the restenosis group. (p>0.05).