title: Hyperhomocysteinemia and recurrent carotid stenosis.
abstract: BACKGROUND
  Hyperhomocysteinemia has been identified as a potential risk for atherosclerotic disease in epidemiologic studies. This study investigates the impact of elevated serum homocysteine on restenosis after carotid endarterectomy (CEA).
  
  
  METHODS
  In a retrospective study, we compared fasting plasma homocysteine levels of 51 patients who developed restenosis during an eight year period after CEA with 45 patients who did not develop restenosis. Restenosis was defined as at least 50% stenosis and was assessed by applying a routine duplex scan follow up investigation. Patients with restenosis were divided into a group with early restenosis (between 3 and 18 months postoperative, a total of 39 patients) and late restenosis (19 and more months; a total of 12 patients).
  
  
  RESULTS
  The groups were controlled for age, sex, and risk factors such as diabetes, nicotine abuse, weight, hypertension, and hyperlipidemia. Patients with restenosis had a significant lower mean homocysteine level (9.11 micromol/L; range: 3.23 micromol/L to 26.49 micromol/L) compared to patients without restenosis (11.01 miccromol/L; range: 5.09 micromol/L to 23.29 micromol/L; p = 0.03). Mean homocysteine level in patients with early restenosis was 8.88 micromol/L (range: 3.23-26.49 micromol/L) and 9.86 micromol/L (range 4.44-19.06 micromol/L) in late restenosis (p = 0.50).
  
  
  CONCLUSIONS
  The finding suggests that high plasma homocysteine concentrations do not play a significant role in the development of restenosis following CEA.
authors.affiliation: Department of Vascular and Thoracic Surgery, University of Ulm, Ulm, German. Hillenbrand.Renata@web.de
authors.forename: Renata
authors.initials: R
authors.lastname: Hillenbrand
authors.forename: Andreas
authors.initials: A
authors.lastname: Hillenbrand
authors.forename: Florian
authors.initials: F
authors.lastname: Liewald
authors.forename: Julian
authors.initials: J
authors.lastname: Zimmermann
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016893:Carotid Stenosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000601:surgery*; D016022:Case-Control Studies; D003251:Constriction, Pathologic; D016894:Endarterectomy, Carotid / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011336:Probability; D012008:Recurrence; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012737:Sex Factors; D018616:Ultrasonography, Doppler, Duplex
chemical_list: D015415:Biomarkers; D006710:Homocysteine