Holotranscobalamin and methylmalonic acid as prognostic markers following an acute myocardial infarction.
OBJECTIVE
To evaluate whether low levels of holotranscobalamin (holoTC) or elevated levels of methylmalonic acid (MMA), both indicators of vitamin B(12) deficiency, might predispose to new cardiovascular events following an acute myocardial infarction (MI).


METHODS
A prospective prognostic study.


METHODS
One hospital center in Stavanger, Norway.


METHODS
A total of 300 patients admitted with an acute MI.


METHODS
Registration of new TnT positive coronary events (defined as TnT>0.05 microg/l and a typical MI pattern) and/or cardiac death during a median follow-up time of 45 months.


RESULTS
We compared the recurrence of events in the lowest quartile of holoTC (Q1<73.9 pmol/l) to the event rate above the 25% percentile (Q2-4). For methylmalonic acid (MMA) the same comparison was carried out for the upper quartile (Q4 > or =0.24 micromol/l) as compared with the event rate below the 75% percentile (Q1-3). After 18 and 45 months of follow-up, the odds ratio (OR) for Q1 vs Q2-4 for holoTC was 1.15 (95% confidence interval (CI) 0.91-1.46, P=0.25) and 1.05 (95% CI 0.86-1.29, P=0.64), respectively. For MMA the OR for Q4 vs Q1-3 was 0.95 (95% CI 0.76-1.19, P=0.67) after 18 months and 1.01 (95% CI 0.83-1.23, P=0.90) after 45 months.


CONCLUSIONS
This study showed no increased risk of future cardiovascular events associated with low levels of holoTC or high levels of MMA following an acute MI.
Aarsetøy
H
H
Department of Medicine, Stavanger University Hospital, Stavanger, Norway. aahi@sus.no
Valente
E
E
Reine
A
A
Mansoor
M A
MA
Grundt
H
H
Nilsen
D W T
DW
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006710:Homocysteine / Q000097:blood; D006801:Humans; D008297:Male; D008764:Methylmalonic Acid / Q000097:blood*; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis; D016017:Odds Ratio; D011379:Prognosis; D012008:Recurrence; D013997:Time Factors; D014155:Transcobalamins / Q000378:metabolism*; D014805:Vitamin B 12 / Q000097:blood; D014806:Vitamin B 12 Deficiency / Q000097:blood* / Q000150:complications / Q000175:diagnosis
D015415:Biomarkers; D014155:Transcobalamins; D006710:Homocysteine; D008764:Methylmalonic Acid; D014805:Vitamin B 12