A prospective patient observational study of the role of hyperhomocysteinemia in restenosis in patients undergoing infrainguinal angioplasty or bypass procedures.
OBJECTIVE
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.
Hansrani
M
M
Department of Surgery, Freeman Hospital, Newcastle upon Tyne, UK.
Oates
C
C
Stansby
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D017130:Angioplasty; D050197:Atherosclerosis / Q000097:blood / Q000209:etiology* / Q000601:surgery*; D005260:Female; D006119:Groin; D006710:Homocysteine / Q000097:blood; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence
D006710:Homocysteine