title: Combination of biomarkers to predict mortality in elderly patients with myocardial infarction.
abstract: OBJECTIVE
  The elderly subjects affected by Acute Myocardial Infarction (AMI) have the highest risk of mortality. Our study was designed to improve the capability of mortality risk stratification in elderly AMI patients through the concurrent evaluations of different biomarkers, including genetic markers.
  
  
  RESULTS
  One-year follow-up study was performed in 250 elderly AMI patients. The combination of high total Homocysteine (tHcy), low folate and vitamin B12 plasma levels (18.0+/-9.0 micromol/l; 4.4+/-1.2 ng/ml; 404.2+/-287.5 pg/ml, respectively) and elevated CRP plasma levels (> or =6 mg/dl) identify the highest-risk pathway of heart mortality (RR=4.20, IC 95% 1.62-10.89, P<0.002) with respect to the combination of low total tHcy, high folate and vitamin B12 plasma levels (12.4+/-5.2 micromol/l; 8.9+/-2.5 ng/ml; 546.9+/-379.8 pg/ml, respectively) and low CRP plasma levels (<6 mg/dl).
  
  
  CONCLUSIONS
  In elderly AMI patients the concomitant elevation of CRP and tHcy, associated with folate and vitamin B12 low levels, could be considered a significant predictive heart mortality risk factor.
authors.affiliation: Center of Genetic and Molecular Biology, Cardiology-CCU Unit, Center of Statistics, Center of Immunology and Nutrigenomics, Center of Citology, Italian National Research Centers on Aging (I.N.R.C.A.), Ancona, Italy. b.molecolare@inrca.it
authors.forename: Fabiola
authors.initials: F
authors.lastname: Olivieri
authors.forename: Liana
authors.initials: L
authors.lastname: Spazzafumo
authors.forename: Roberto
authors.initials: R
authors.lastname: Antonicelli
authors.forename: Francesca
authors.initials: F
authors.lastname: Marchegiani
authors.forename: Maurizio
authors.initials: M
authors.lastname: Cardelli
authors.forename: Cristina
authors.initials: C
authors.lastname: Sirolla
authors.forename: Roberta
authors.initials: R
authors.lastname: Galeazzi
authors.forename: Simona
authors.initials: S
authors.lastname: Giovagnetti
authors.forename: Eugenio
authors.initials: E
authors.lastname: Mocchegiani
authors.forename: Claudio
authors.initials: C
authors.lastname: Franceschi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality*; D015996:Survival Rate
chemical_list: D015415:Biomarkers