[Mild hyperhomocysteinemia, low folate levels and prognosis of acute coronary syndrome without ST elevation].

Autor:	García-Pinilla JM; Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, España. pinilla@secardiologia.es, Espinosa-Caliani S, Gómez-Doblas JJ, Jiménez-Navarro MF, Cabrera-Bueno F, Muñoz Morán E, Ruiz-Galdón M, Reyes-Engel A, de Teresa Galván E
Jazyk:	Spanish; Castilian
Zdroj:	Medicina clinica [Med Clin (Barc)] 2007 Sep 08; Vol. 129 (8), pp. 281-6.
DOI:	10.1157/13109705
Abstrakt:	Background and Objective: The influence of homocysteine metabolism on the prognosis of acute coronary syndrome without ST elevation is controversial. Patients and Method: Prospective study of 109 patients admitted because of acute coronary syndrome without ST elevation. Basal plasmatic levels of homocysteine and folates were obtained. Clinical features and survival data on follow-up were registered. Results: Both two years-free-of-events and total survival were lower in patients with low folate levels (36.5% vs 72.5%, p = 0.02; 48% vs 94%, p < .001). Patients with high homocysteine levels had lower two years-free-of-events survival (57.4% vs 89.1%, p < .01); but no difference in the total survival was observed (86.3% vs 97.3%, p = 0.11). The multivariate analysis showed that low folate levels was an independent predictor of mortality (odds ratio [OR] = 8.33; 95% confidence interval [CI], 1.88-33.33; p < 0.01), and moderate high homocysteine was an independent predictor of events on follow-up (OR = 4.34; 95% CI, 1.47-12.50; p < 0.01). Conclusions: Patients with high homocysteine or low folate levels have a poor prognosis compared with those with normal levels. On the other hand, low folate levels and moderate hyiperhomocysteinemia are independent predictors of bad prognosis in the follow-up.
Databáze:	MEDLINE
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