Combination of biomarkers to predict mortality in elderly patients with myocardial infarction.
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.
Olivieri
Fabiola
F
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
Spazzafumo
Liana
L
Antonicelli
Roberto
R
Marchegiani
Francesca
F
Cardelli
Maurizio
M
Sirolla
Cristina
C
Galeazzi
Roberta
R
Giovagnetti
Simona
S
Mocchegiani
Eugenio
E
Franceschi
Claudio
C
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
D015415:Biomarkers