The Effect of Plasma Homocysteine Levels on Clinical Outcomes of Patients With Acute Lung Injury/Acute Respiratory Distress Syndrome
| Autor: | Tsangaris, I., Tsantes, Argirio E., Bagos, Pantelis G., Nikolopoulos, Georgios K., Kroupis, C., Kopterides, Petros, Dimopoulou, Ioanna, Orfanos, S., Kardoulaki, A., Chideriotis, S., Travlou, Anthi S., Armaganidis, Apostolos |
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| Přispěvatelé: | Nikolopoulos, Georgios K.[0000-0002-3307-0246], Bagos, Pantelis G. [0000-0003-4935-2325], Kopterides, Petros [0000-0002-7682-4482], Armaganidis, Apostolos [0000-0002-6630-2648] |
| Rok vydání: | 2009 |
| Předmět: |
Male
ARDS Time Factors Folic acid Homocysteine medicine.medical_treatment Gastroenterology chemistry.chemical_compound Artificial ventilation Adult respiratory distress syndrome Blood plasma Acute lung injury Protein blood level Single nucleotide Middle aged Diffuse alveolar damage Protein c Respiratory Distress Syndrome Methylenetetrahydrofolate reductase (nadph2) Acute respiratory distress syndrome biology Respiratory disease General Medicine Middle Aged Prognosis Blood Creatinine Cyanocobalamin Female Amino acid blood level Human Adult medicine.medical_specialty Mthfr c677t polymorphism Genotype Respiratory distress syndrome Acute Lung Injury Major clinical study Lung injury Polymorphism Single Nucleotide Dna polymorphism Article Time Mthfr a1298c polymorphism Internal medicine Plasminogen Activator Inhibitor 1 Genetics medicine Humans Clinical evaluation Creatinine blood level Serpine1 protein Mortality Polymorphism Plasminogen activator inhibitor 1 Methylenetetrahydrofolate Reductase (NADPH2) Aged Mechanical ventilation business.industry Time factors medicine.disease Single nucleotide polymorphism Plasma homocysteine Surgery Outcome assessment Metabolism chemistry Methylenetetrahydrofolate reductase Enzymology biology.protein business 10 methylenetetrahydrofolate reductase (fadh2) Protein C |
| Zdroj: | American Journal of the Medical Sciences |
| ISSN: | 0002-9629 |
| DOI: | 10.1097/maj.0b013e3181b97c00 |
| Popis: | Background Several reports have shown that homocysteine promotes thrombosis by disturbing the procoagulant-anticoagulant balance, whereas alterations in coagulation and fibrinolysis have been suggested as important pathogenetic and prognostic determinants of mortality in acute lung injury (ALI)/acute respiratory distress syndrome (ARDS). The objective of the study was to evaluate the effect of plasma homocysteine levels on the outcomes of patients with ALI/ARDS. Methods Sixty-nine consecutive ventilated patients with ALI/ARDS were studied. Blood samples were drawn within 3 days of clinical recognition of ARDS. Measurement of plasma homocysteine, vitamin B12, folate, creatinine, protein C and plasminogen-activator inhibitor-1 antigen levels, and genotyping of the methylenetetrahydrofolate reductase gene C677T and A1298C polymorphisms were carried out. The primary outcomes were 28- and 90-day mortality, whereas secondary outcomes included nonpulmonary organ failure-free days, liberation from mechanical ventilation up to day 28, and ventilator-free days during the 28 days after enrollment. Results In the multivariable analysis, plasma homocysteine concentration adjusted for age, Acute Physiology and Chronic Health Evaluation II score, methylenetetrahydrofolate reductase C677T and A1298C polymorphisms, and levels of plasminogen-activator inhibitor-1 antigen, protein C, creatinine, vitamin B12, and folate was not found to affect significantly mortality at 28 and 90 days ( P = 0.39 and P = 0.83, respectively), days without organ failure besides lungs ( P = 0.38), the probability of being free from mechanical ventilation at day 28 ( P = 0.63), and days without ventilation assistance ( P = 0.73). Conclusion Our data suggest that increased plasma homocysteine levels, either alone or in synergy with other thrombophilic risk factors, do not seem to adversely affect the prognosis in patients with ALI/ARDS. |
| Databáze: | OpenAIRE |
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