AIM: The prognostic value of homocysteine (HCY) in patients with coronary artery diseases (CAD) is still controversial. The objective of this study was to investigate whether elevated HCY level at admission predict long-term outcomes in patients after percutaneous coronary interventions (PCI) with coronary artery stenting. METHODS: From the institutional registry of Cardiovascular Atherosclerosis and Percutaneous TrAnsluminal INterventions (CAPTAIN), we enrolled a total of 1,307 patients with documented CAD undergone PCI with bare metal stents from July 2003 to December 2014. They were divided into two groups according to the fasting plasma HCY levels before catheterization: group Ⅰ (883 patients, ＜12 µmol/L) and group II (424 patients, ≥12 µmol/L). The primary endpoint was occurrence of major adverse cardiac events (MACE), including cardiac death, nonfatal myocardial infarction, stroke, target lesion revascularization, new lesion stenting, and requiring bypass surgery. RESULTS: After a mean follow-up period of 58±41 months, the group II patients had a higher MACE rate (33.3% vs. 25.6%, p=0.005). The main differences between two groups were cardiac death (8.0% vs. 3.4%, p=0.001) and new lesion stenting (13.6% vs. 9.5%, p=0.034). The risks of long-term MACE remained significantly higher in patients with elevated HCY level (≥12 µmol/L) after adjusting for clinical variables, with a hazard ratio of 1.29 (95% CI, 1.02-1.64, p=0.036). CONCLUSIONS: Elevated HCY level (≥12 µmol/L) was independently associated with increased risk of long-term cardiovascular events in patients after coronary artery bare metal stents implantations. Thus, hyperhomocysteinemia may remain a useful prognostic marker for the risk assessment in clinical care of CAD patients.
AIM: The prognostic value of homocysteine (HCY) in patients with coronary artery diseases (CAD) is still controversial. The objective of this study was to investigate whether elevated HCY level at admission predict long-term outcomes in patients after percutaneous coronary interventions (PCI) with coronary artery stenting. METHODS: From the institutional registry of Cardiovascular Atherosclerosis and Percutaneous TrAnsluminal INterventions (CAPTAIN), we enrolled a total of 1,307 patients with documented CAD undergone PCI with bare metal stents from July 2003 to December 2014. They were divided into two groups according to the fasting plasma HCY levels before catheterization: group Ⅰ (883 patients, ＜12 µmol/L) and group II (424 patients, ≥12 µmol/L). The primary endpoint was occurrence of major adverse cardiac events (MACE), including cardiac death, nonfatal myocardial infarction, stroke, target lesion revascularization, new lesion stenting, and requiring bypass surgery. RESULTS: After a mean follow-up period of 58±41 months, the group II patients had a higher MACE rate (33.3% vs. 25.6%, p=0.005). The main differences between two groups were cardiac death (8.0% vs. 3.4%, p=0.001) and new lesion stenting (13.6% vs. 9.5%, p=0.034). The risks of long-term MACE remained significantly higher in patients with elevated HCY level (≥12 µmol/L) after adjusting for clinical variables, with a hazard ratio of 1.29 (95% CI, 1.02-1.64, p=0.036). CONCLUSIONS: Elevated HCY level (≥12 µmol/L) was independently associated with increased risk of long-term cardiovascular events in patients after coronary artery bare metal stents implantations. Thus, hyperhomocysteinemia may remain a useful prognostic marker for the risk assessment in clinical care of CAD patients.
Authors: Mariska Klerk; Petra Verhoef; Robert Clarke; Henk J Blom; Frans J Kok; Evert G Schouten Journal: JAMA Date: 2002 Oct 23-30 Impact factor: 56.272
Authors: J Duan; T Murohara; H Ikeda; K Sasaki; S Shintani; T Akita; T Shimada; T Imaizumi Journal: Arterioscler Thromb Vasc Biol Date: 2000-12 Impact factor: 8.311
Authors: James F Toole; M René Malinow; Lloyd E Chambless; J David Spence; L Creed Pettigrew; Virginia J Howard; Elizabeth G Sides; Chin-Hua Wang; Meir Stampfer Journal: JAMA Date: 2004-02-04 Impact factor: 56.272
Authors: M den Heijer; T Koster; H J Blom; G M Bos; E Briet; P H Reitsma; J P Vandenbroucke; F R Rosendaal Journal: N Engl J Med Date: 1996-03-21 Impact factor: 91.245