title: [Association between serum homocysteine and in-hospital death in patients with acute pulmonary embolism].
abstract: OBJECTIVE
  To explore the association between serum homocysteine (Hcy) level and in-hospital death in patients with acute pulmonary embolism.
  
  
  METHODS
  A total of 186 acute pulmonary embolism patients [ (66.8 ± 12.7) years, 89 male] hospitalized in our department between June 2008 and June 2011 were included in this prospective study. Patients were divided into high Hcy group (Hcy ≥ 15.2 µmol/L, n = 95) and low Hcy group (Hcy < 15.2 µmol/L, n = 91). Patients were followed-up for 1 year for the incidence rate of early death associated with acute pulmonary embolism. The Cox proportional hazard model was used to analyze the relationship between serum Hcy level and early death in acute pulmonary embolism patients.
  
  
  RESULTS
  Patients were hospitalized for 1-37 days [(10 ± 6) days]. In-hospital death rate was 14.5% (27/186) and was significantly higher in high Hcy group than in low Hcy group [25.3% (24/95) vs. 3.3% (3/91) , P = 0.001]. Univariate Cox regression analysis indicated that admission heart rate, oxygen saturation, enlargement of right ventricle, Hcy ≥ 15.2 µmol/L, serum creatinine level, peak TnT level and deep venous thrombosis (P < 0.05) were independent risk factors for in-hospital death. Multivariate Cox regression analysis showed that Hcy ≥ 15.2 µmol/L (HR = 4.10, 95%CI:3.00-4.98, P = 0.017), admission heart rate (HR = 1.10, 95%CI:1.01-1.20, P = 0.031) , deep venous thrombosis (HR = 1.65, 95%CI:1.45-1.76, P = 0.034) and age (HR = 1.10, 95%CI:1.02-1.19, P = 0.010) were independent predictors of in-hospital death for acute pulmonary embolism patients. One-year follow up was finished in 142 patients (89.3%). There were 19 deaths ( 5 due to repeat pulmonary embolism, 4 due to decompensated respiratory and /or cardiac diseases, 6 due to malignant tumors, 2 due to fatal bleeding and 2 due to pneumonia) . Death rate was similar between the two groups during follow up.
  
  
  CONCLUSIONS
  Higher serum homocysteine is an independent for in-hospital death for patients with acute pulmonary embolism.
authors: Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors: Hang
authors: H
authors: Zhu
authors: Email: xuehao301@hotmail.com.
authors: Hao
authors: H
authors: Xue
authors: Guang-yi
authors: GY
authors: Wang
authors: You-hong
authors: YH
authors: Xing
authors: Tan-shi
authors: TS
authors: Li
authors: Yuan-yu
authors: YY
authors: Qian
authors: Chao-ying
authors: CY
authors: Peng
authors: Li-xin
authors: LX
authors: Xie
authors: Ye
authors: Y
authors: Hu
mesh_terms: D000368:Aged; D005260:Female; D006710:Homocysteine / Q000097:blood*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000097:blood* / Q000401:mortality*; D012307:Risk Factors
chemical_list: D006710:Homocysteine