PMID- 15528477
OWN - NLM
STAT- MEDLINE
DCOM- 20050804
LR  - 20071115
IS  - 1524-4636 (Electronic)
IS  - 1079-5642 (Linking)
VI  - 25
IP  - 1
DP  - 2005 Jan
TI  - Hyperhomocysteinemia is inversely related with left ventricular ejection fraction 
      and predicts cardiovascular mortality in high-risk coronary artery disease 
      hypertensives.
PG  - 115-21
AB  - OBJECTIVE: The purpose of this study was to investigate the relationship of 
      plasma homocysteine (tHcy) levels with coronary artery disease (CAD) and left 
      ventricular ejection fraction (LVEF) in high-risk patients undergoing coronary 
      angiography for suspected CAD. METHODS AND RESULTS: In 936 consecutive patients, 
      we measured LVEF, tHcy, folate levels, and quantified CAD with a modified Duke 
      Index score. We also genotyped patients at the 
      methylen-tetrahydrofolate-reductase 677C-->T polymorphism. Hyperhomocysteinemia 
      (HHcy) was defined as tHcy levels > or =15.46 micromol/L; total and 
      cardiovascular mortality was assessed at follow-up that lasted 43 months 
      (median). CAD was confirmed in 75% of patients and ruled out in the rest (non-CAD 
      group). No relationship of HHcy with either arterial hypertension or the CAD 
      score was found. In contrast, there was a significant inverse relationship of 
      tHcy with LVEF in arterial hypertensive but not in normotensive patients, 
      regardless of previous myocardial infarction. At logistic regression, HHcy was 
      the strongest predictor (P=0.001) of a low (<40%) LVEF, followed by type 2 
      diabetes mellitus and cigarette smoking. At follow-up, HHcy significantly 
      predicted cardiovascular mortality but only in the arterial hypertension 
      subgroup. CONCLUSIONS: In arterial hypertensive but not in normotensive patients, 
      HHcy predicts cardiovascular mortality and a low LVEF, independent of CAD and 
      history of myocardial infarction.
FAU - Cesari, Maurizio
AU  - Cesari M
AD  - DMCS Clinica Medica 4, University of Padova, Italy.
FAU - Zanchetta, Mario
AU  - Zanchetta M
FAU - Burlina, Alberto
AU  - Burlina A
FAU - Pedon, Luigi
AU  - Pedon L
FAU - Maiolino, Giuseppe
AU  - Maiolino G
FAU - Sticchi, Daniele
AU  - Sticchi D
FAU - Pessina, Achille C
AU  - Pessina AC
FAU - Rossi, Gian Paolo
AU  - Rossi GP
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20041104
PL  - United States
TA  - Arterioscler Thromb Vasc Biol
JT  - Arteriosclerosis, thrombosis, and vascular biology
JID - 9505803
RN  - EC 1.5.1.15 (Methylenetetrahydrofolate Dehydrogenase (NAD+))
SB  - IM
MH  - Coronary Artery Disease/*mortality
MH  - Follow-Up Studies
MH  - Humans
MH  - Hyperhomocysteinemia/*metabolism/*pathology
MH  - Longitudinal Studies
MH  - Methylenetetrahydrofolate Dehydrogenase (NAD+)
MH  - Middle Aged
MH  - Ventricular Dysfunction, Left/metabolism
MH  - Ventricular Function, Left/*physiology
EDAT- 2004/11/06 09:00
MHDA- 2005/08/05 09:00
CRDT- 2004/11/06 09:00
PHST- 2004/11/06 09:00 [pubmed]
PHST- 2005/08/05 09:00 [medline]
PHST- 2004/11/06 09:00 [entrez]
AID - 01.ATV.0000149674.62430.e7 [pii]
AID - 10.1161/01.ATV.0000149674.62430.e7 [doi]
PST - ppublish
SO  - Arterioscler Thromb Vasc Biol. 2005 Jan;25(1):115-21. doi: 
      10.1161/01.ATV.0000149674.62430.e7. Epub 2004 Nov 4.