title: Clinical relevance of homocysteine levels in patients receiving coronary stenting for unstable angina.
abstract: 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.
authors.affiliation: Institute of Cardiology, University of Bologna, Bologna, Italy. paortol@tin.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Ortolani
authors.forename: Antonio
authors.initials: A
authors.lastname: Marzocchi
authors.forename: Cinzia
authors.initials: C
authors.lastname: Marrozzini
authors.forename: Tullio
authors.initials: T
authors.lastname: Palmerini
authors.forename: Matteo
authors.initials: M
authors.lastname: Aquilina
authors.forename: Leonardo
authors.initials: L
authors.lastname: Corlianò
authors.forename: Francesco
authors.initials: F
authors.lastname: Saia
authors.forename: Nevio
authors.initials: N
authors.lastname: Taglieri
authors.forename: Paolo
authors.initials: P
authors.lastname: Sbarzaglia
authors.forename: Maria Letizia
authors.initials: ML
authors.lastname: Bacchi Reggiani
authors.forename: Angelo
authors.initials: A
authors.lastname: Branzi
mesh_terms: 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
chemical_list: D015415:Biomarkers; D006710:Homocysteine; D002097:C-Reactive Protein