Italian heart journal : official journal of the Italian Federation of Cardiology · 2004
Clinical relevance of homocysteine levels in patients receiving coronary stenting for unstable angina.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Ortolani Paolo, Marzocchi Antonio, Marrozzini Cinzia, Palmerini Tullio, Aquilina Matteo, Corlianò Leonardo, Saia Francesco, Taglieri Nevio, Sbarzaglia Paolo, Bacchi Reggiani Maria Letizia, Branzi Angelo
Аннотация
BACKGROUND: We prospectively investigated whether plasma homocysteine (HCY) concentrations are related to target lesion revascularization (TLR) rates in patients with unstable angina undergoing stenting.
METHODS: We enrolled 196 consecutive patients with at least one successful coronary stent implantation for unstable angina.
RESULTS: The mean vessel diameter was 3.1 +/- 0.5 mm. At follow-up (17.8 +/- 7.5 months), patients with higher HCY levels (> 17 micromol/l, 4th quartile) had similar TLR rates to the rest of the sample (11.1 vs 13.2%, p = 0.90). On the other hand, high HCY levels did seem to be associated with higher total (13.3 vs 0.7%, p = 0.001) and cardiac (6.7 vs 0%, p = 0.01) mortality rates. At multivariate analysis, only target vessel diameter independently predicted TLR, while both HCY levels and target vessel size predicted late total mortality.
CONCLUSIONS: At least in patients with a mean vessel diameter > 3 mm, HCY levels cannot be taken as a prognostic indicator of in-stent restenosis for patients with unstable angina. However, in spite of successful percutaneous revascularization, HCY values do seem to strongly influence late mortality.
METHODS: We enrolled 196 consecutive patients with at least one successful coronary stent implantation for unstable angina.
RESULTS: The mean vessel diameter was 3.1 +/- 0.5 mm. At follow-up (17.8 +/- 7.5 months), patients with higher HCY levels (> 17 micromol/l, 4th quartile) had similar TLR rates to the rest of the sample (11.1 vs 13.2%, p = 0.90). On the other hand, high HCY levels did seem to be associated with higher total (13.3 vs 0.7%, p = 0.001) and cardiac (6.7 vs 0%, p = 0.01) mortality rates. At multivariate analysis, only target vessel diameter independently predicted TLR, while both HCY levels and target vessel size predicted late total mortality.
CONCLUSIONS: At least in patients with a mean vessel diameter > 3 mm, HCY levels cannot be taken as a prognostic indicator of in-stent restenosis for patients with unstable angina. However, in spite of successful percutaneous revascularization, HCY values do seem to strongly influence late mortality.
Предметные рубрики MeSH
AgedAged, 80 and overAngina, UnstableAngioplasty, Balloon, CoronaryBiomarkersBlood Vessel Prosthesis ImplantationC-Reactive ProteinCoronary AngiographyCoronary Artery BypassCoronary StenosisFemaleFollow-Up StudiesHomocysteineHumansItalyMaleMiddle AgedMultivariate AnalysisPredictive Value of TestsProspective StudiesReoperationStentsStroke VolumeSurvival AnalysisTreatment Outcome