AIM: The aim of this study was to examine the correlation between elevated plasma homocysteine (HCy) and restenosis/occlusion in patients undergoing infrainguinal angioplasty or bypass grafting. METHODS: Fifty-three patients presenting to the Northern Vascular Unit were sequentially recruited to the study and prospectively followed up for 12 months post-infrainguinal angioplasty or bypass surgery. Plasma HCy was measured preprocedure and at least 3 months postprocedure using the Abbott IMx system. Hyperhomocysteinemia (HHCy) was taken at a level >15 microM/L. All patients were serially duplex scanned at 6 weeks, and 3, 6, 9 and 12 months. Kaplan-Meier analysis was performed to assess the restenosis/occlusion rate in patients with HHCy versus controls. Analysis of correlation between risk factors for restenosis/occlusion was performed using the Pearson correlation coefficient. In addition, logistic regression analysis was performed. RESULTS: Forty-eight percent of procedures was performed in patients with HHCy. There were 18 graft stenoses/occlusions, and 13 restenoses/occlusions postangioplasty. HHCy did not correlate with an increased risk of restenosis/occlusion (P=0.79). There was a significant correlation between HCy, age, folate and cholesterol levels. Logistic regression analysis revealed no factors that correlated with failure of therapeutic intervention. CONCLUSIONS: This study does not support the hypothesis that HHCy is associated with an increased risk of restenosis after vascular intervention.
AIM: The aim of this study was to examine the correlation between elevated plasma homocysteine (HCy) and restenosis/occlusion in patients undergoing infrainguinal angioplasty or bypass grafting. METHODS: Fifty-three patients presenting to the Northern Vascular Unit were sequentially recruited to the study and prospectively followed up for 12 months post-infrainguinal angioplasty or bypass surgery. Plasma HCy was measured preprocedure and at least 3 months postprocedure using the Abbott IMx system. Hyperhomocysteinemia (HHCy) was taken at a level >15 microM/L. All patients were serially duplex scanned at 6 weeks, and 3, 6, 9 and 12 months. Kaplan-Meier analysis was performed to assess the restenosis/occlusion rate in patients with HHCy versus controls. Analysis of correlation between risk factors for restenosis/occlusion was performed using the Pearson correlation coefficient. In addition, logistic regression analysis was performed. RESULTS: Forty-eight percent of procedures was performed in patients with HHCy. There were 18 graft stenoses/occlusions, and 13 restenoses/occlusions postangioplasty. HHCy did not correlate with an increased risk of restenosis/occlusion (P=0.79). There was a significant correlation between HCy, age, folate and cholesterol levels. Logistic regression analysis revealed no factors that correlated with failure of therapeutic intervention. CONCLUSIONS: This study does not support the hypothesis that HHCy is associated with an increased risk of restenosis after vascular intervention.