Plasma homocysteine and severity of thoracic aortic atherosclerosis.
OBJECTIVE
Plasma homocysteine level is a risk factor for coronary events, stroke, and peripheral atherosclerotic disease. However, few data are available concerning the relationship between homocysteine level and severity of thoracic aortic atherosclerosis. We hypothesized in this multiplane transesophageal echocardiography (TEE) study that homocysteine level is a marker of the presence and severity of thoracic aortic atherosclerosis.


METHODS
Cross-sectional study.


METHODS
University hospital.


METHODS
Risk factors, angiographic features, and TEE findings were analyzed prospectively in 82 valvular patients.


RESULTS
The following risk factors were recorded: age, gender, hypertension, smoking, lipid parameters, diabetes, body mass index, and family history of coronary artery disease. Plasma levels of homocysteine, vitamin B(12), and folic acid were measured for each patient. By univariate analysis, age, diabetes, hypertension, smoking, family history of coronary artery disease, and levels of homocysteine, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were significant predictors of the presence of thoracic aortic plaques. There was a positive correlation between the plasma homocysteine levels and the score of severity of thoracic atherosclerosis (r = 0.48; p = 0.0001) as well as between the homocysteine levels and the grades of severity of aortic intimal changes (p = 0.0008). Multivariate regression analysis revealed that homocysteine was an independent predictor of the presence and severity of thoracic aortic atherosclerosis.


CONCLUSIONS
This prospective study indicates that plasma homocysteine level is a marker of severity of thoracic atherosclerosis detected by multiplane TEE. These findings emphasize the role of homocysteine as a marker of atherosclerotic lesions in the major arterial locations.
Tribouilloy
C M
CM
Department of Cardiology, South Hospital, University of Picardie, Amiens, France.
Peltier
M
M
Iannetta Peltier
M C
MC
Trojette
F
F
Andrejak
M
M
Lesbre
J P
JP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic; D001018:Aortic Diseases / Q000097:blood* / Q000175:diagnosis / Q000000981:diagnostic imaging; D001161:Arteriosclerosis / Q000097:blood* / Q000175:diagnosis / Q000000981:diagnostic imaging; D015415:Biomarkers / Q000097:blood; D002784:Cholesterol / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood; D003430:Cross-Sectional Studies; D017548:Echocardiography, Transesophageal; D005260:Female; D005492:Folic Acid / Q000097:blood; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D014805:Vitamin B 12 / Q000097:blood
D015415:Biomarkers; D006710:Homocysteine; D005492:Folic Acid; D002784:Cholesterol; D014805:Vitamin B 12