Association of elevated plasma homocysteine levels with impaired ST-segment resolution after fibrinolytic therapy in acute ST-elevation myocardial infarction.
OBJECTIVE
Elevated plasma homocysteine levels are associated with increased intracoronary thrombus burden in acute coronary syndromes. The relationship between plasma homocysteine levels and ST-segment resolution (STR) after fibrinolytic therapy has, however, not been investigated. We sought to investigate this issue.


METHODS
Forty-nine patients who were administered fibrinolytic therapy for ST-segment elevation myocardial infarction (STEMI) were included in this study. Maximum STR was measured after 90 min of fibrinolytic therapy. Patients with a maximum STR of less than 50% were included in group 1. Patients with a maximum STR >or=50% were included in group 2. Blood samples were collected from the antecubital vein upon arrival to the hospital. The plasma was separated and kept at -70 degrees C until the time of analysis. Total plasma homocysteine level was determined by the high-performance liquid chromatography method with fluorescence detection.


RESULTS
Fifteen patients in group 1 and 34 patients in group 2 were present. Baseline characteristics were similar in both groups. The plasma homocysteine levels were 22.5+/-10 micromol/l in group 1 and 14.1+/-4 micromol/l in group 2 (P<0.001).


CONCLUSIONS
Elevated plasma homocysteine levels are associated with impaired STR after fibrinolytic therapy in acute STEMI.
Yeter
Ekrem
E
Department of Cardiology, Atatürk Education and Research Hospital, Ankara, Turkey. ekremyeter@hotmail.com
Ozdemir
Levent
L
Keleş
Telet
T
Durmaz
Tahir
T
Akçay
Murat
M
Akarbayram
Nihal
N
Yüksel
Isa
I
Bozkurt
Engin
E
D000368:Aged; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D004562:Electrocardiography; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology*
D015415:Biomarkers; D005343:Fibrinolytic Agents; D006710:Homocysteine