title: [Mild hyperhomocysteinemia, low folate levels and prognosis of acute coronary syndrome without ST elevation].
abstract: OBJECTIVE
  The influence of homocysteine metabolism on the prognosis of acute coronary syndrome without ST elevation is controversial.
  
  
  METHODS
  Prospective study of 109 patients admitted because of acute coronary syndrome without ST elevation. Basal plasmatic levels of homocysteine and folates were obtained. Clinical features and survival data on follow-up were registered.
  
  
  RESULTS
  Both two years-free-of-events and total survival were lower in patients with low folate levels (36.5% vs 72.5%, p = 0.02; 48% vs 94%, p < .001). Patients with high homocysteine levels had lower two years-free-of-events survival (57.4% vs 89.1%, p < .01); but no difference in the total survival was observed (86.3% vs 97.3%, p = 0.11). The multivariate analysis showed that low folate levels was an independent predictor of mortality (odds ratio [OR] = 8.33; 95% confidence interval [CI], 1.88-33.33; p < 0.01), and moderate high homocysteine was an independent predictor of events on follow-up (OR = 4.34; 95% CI, 1.47-12.50; p < 0.01).
  
  
  CONCLUSIONS
  Patients with high homocysteine or low folate levels have a poor prognosis compared with those with normal levels. On the other hand, low folate levels and moderate hyiperhomocysteinemia are independent predictors of bad prognosis in the follow-up.
authors: Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, España. pinilla@secardiologia.es
authors: José M
authors: JM
authors: García-Pinilla
authors: Salvador
authors: S
authors: Espinosa-Caliani
authors: Juan J
authors: JJ
authors: Gómez-Doblas
authors: Manuel F
authors: MF
authors: Jiménez-Navarro
authors: Fernando
authors: F
authors: Cabrera-Bueno
authors: Encarnación
authors: E
authors: Muñoz Morán
authors: Maximiliano
authors: M
authors: Ruiz-Galdón
authors: Armando
authors: A
authors: Reyes-Engel
authors: Eduardo
authors: E
authors: de Teresa Galván
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D005494:Folic Acid Deficiency / Q000453:epidemiology*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D011379:Prognosis; D012720:Severity of Illness Index