Clinical relevance of homocysteine levels in patients receiving coronary stenting for unstable angina.
BACKGROUND
We prospectively investigated whether plasma homocysteine (HCY) concentrations are related to target lesion revascularization (TLR) rates in patients with unstable angina undergoing stenting.


METHODS
We enrolled 196 consecutive patients with at least one successful coronary stent implantation for unstable angina.


RESULTS
The mean vessel diameter was 3.1 +/- 0.5 mm. At follow-up (17.8 +/- 7.5 months), patients with higher HCY levels (> 17 micromol/l, 4th quartile) had similar TLR rates to the rest of the sample (11.1 vs 13.2%, p = 0.90). On the other hand, high HCY levels did seem to be associated with higher total (13.3 vs 0.7%, p = 0.001) and cardiac (6.7 vs 0%, p = 0.01) mortality rates. At multivariate analysis, only target vessel diameter independently predicted TLR, while both HCY levels and target vessel size predicted late total mortality.


CONCLUSIONS
At least in patients with a mean vessel diameter > 3 mm, HCY levels cannot be taken as a prognostic indicator of in-stent restenosis for patients with unstable angina. However, in spite of successful percutaneous revascularization, HCY values do seem to strongly influence late mortality.
Ortolani
Paolo
P
Institute of Cardiology, University of Bologna, Bologna, Italy. paortol@tin.it
Marzocchi
Antonio
A
Marrozzini
Cinzia
C
Palmerini
Tullio
T
Aquilina
Matteo
M
Corlianò
Leonardo
L
Saia
Francesco
F
Taglieri
Nevio
N
Sbarzaglia
Paolo
P
Bacchi Reggiani
Maria Letizia
ML
Branzi
Angelo
A
D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000378:metabolism* / Q000401:mortality / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood; D019917:Blood Vessel Prosthesis Implantation; D002097:C-Reactive Protein / Q000378:metabolism; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000378:metabolism / Q000401:mortality / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006710:Homocysteine / Q000378:metabolism*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012086:Reoperation; D015607:Stents; D013318:Stroke Volume / Q000502:physiology; D016019:Survival Analysis; D016896:Treatment Outcome
D015415:Biomarkers; D006710:Homocysteine; D002097:C-Reactive Protein