Influence of high homocysteine and low folate plasmatic levels in medium-term prognosis after acute coronary syndromes.

Autor: García-Pinilla JM; Cardiology Department, Hospital Universitario Virgen de la Victoria, School of Medicine, University of Malaga, Spain., Espinosa-Caliani S, Gómez-Doblas JJ, Jiménez-Navarro M, Gaitán MJ, Muñoz-Morán E, Cabrera-Bueno F, Hernández-García JM, Ortega-Jiménez MV, Ruiz-Galdón M, Reyes-Engel A, de Teresa-Galván E
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2007 May 31; Vol. 118 (2), pp. 220-6. Date of Electronic Publication: 2006 Oct 04.
DOI: 10.1016/j.ijcard.2006.06.053
Abstrakt: Background: To test prospectively whether moderate hyperhomocysteinemia and low folate levels could have an influence in the prognosis of 155 patients who presented with an acute coronary syndrome.
Methods and Results: After a mean follow-up of 13.4+/-7.4 months, patients with low folate levels had higher percentages of cardiovascular death and major cardiovascular events (33% vs. 5%, p<0.001; 44% vs. 22%, p<0.05) and patients with high homocysteine levels had a higher percentage of major cardiovascular events (31% vs. 14.5%, p<0.03). Kaplan-Meier survival estimates analysis showed that patients with low folate levels had a significantly higher probability of cardiovascular death and lower free-of-events survival (log rank statistic: 21.17, p<0.001 and 6.59, p=0.01). Patients with high homocysteine levels had a lower free-of-events survival (log rank statistic: 4.95, p=0.02). Different survival multivariate analysis model showed that the presence of low folate levels was an independent predictor of cardiovascular death (hazard ratio 8.85, 95% confidence interval 2.6-29.3, p<0.000) and high homocysteine levels was identified as independent predictor of major cardiovascular events (hazard ratio 2.34, 95% confidence interval 1.07-5.12, p<0.03).
Conclusions: Low folate levels and moderate hyperhomocysteinemia were identified as independent predictors of cardiovascular events in the follow-up.
Databáze: MEDLINE
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