PMID- 16776625
OWN - NLM
STAT- MEDLINE
DCOM- 20060926
LR  - 20220318
IS  - 1434-6621 (Print)
IS  - 1434-6621 (Linking)
VI  - 44
IP  - 7
DP  - 2006
TI  - Prognostic value of homocysteinemia in patients with congestive heart failure.
PG  - 813-6
AB  - BACKGROUND: Elevated plasma homocysteine levels are associated with increased 
      risk of vascular disease and of congestive heart failure (CHF), with a 
      relationship between homocysteine values and disease severity. 
      Hyperhomocysteinemia is a risk factor for cardiac dysfunction. In this study, the 
      predictive value of elevated homocysteine levels was investigated in the 
      prognosis of ischemic and non-ischemic CHF. METHODS: A total of 159 patients with 
      CHF, 89 with non-ischemic and 70 with ischemic CHF (83% males, mean age 62 years, 
      mean ejection fraction 27%), and 119 controls (79% males, mean age 59.8 years) 
      had fasting blood samples taken to measure plasma homocysteine, vitamin B(12) and 
      folate levels. Coronary angiography was performed for all patients. The mean 
      duration of follow-up was 49.6+/-36.7 months. RESULTS: As in other studies, the 
      mean level of homocysteinemia was significantly higher in the CHF group (15.80 
      micromol/L) than in the control group (10.90 micromol/L) (p=0.001) whatever the 
      etiology (non-ischemic, 16.11+/-6.84 micromol/L; ischemic, 15.41+/-6.45 
      micromol/L). This result was observed without vitamin deficiency, but in 
      patients, the mean creatinine value was moderately higher than in controls. We 
      found a positive correlation between plasma homocysteine levels and New York 
      Heart Association (NYHA) classification, creatinine and age. Moreover, 
      hyperhomocysteinemia appears to be a powerful predictive factor of mortality in 
      CHF patients (relative risk of death, 4.23; p=0.0003). In the follow-up of this 
      study, 41.5% of patients with homocysteinemia >17 micromol/L died vs. 21.3% of 
      patients with levels <17 micromol/L. In multivariate analysis, when homocysteine 
      levels were adjusted for a second parameter (age, NYHA, creatinine, diabetes), 
      the risk of death remained significant after each adjustment. CONCLUSIONS: 
      Elevated homocysteine levels observed in CHF patients, whatever the etiology of 
      their heart disease (ischemic or non-ischemic), were correlated with the severity 
      of the disease. Hyperhomocysteinemia appears to be a predictive factor of 
      mortality in CHF patients.
FAU - Gibelin, Pierre
AU  - Gibelin P
AD  - Cardiology Department, Hopital Pasteur, Nice, France. gibelinp@cote-dazur.com
FAU - Serre, Stephanie
AU  - Serre S
FAU - Candito, Mirande
AU  - Candito M
FAU - Houcher, Bakhouche
AU  - Houcher B
FAU - Berthier, Frederic
AU  - Berthier F
FAU - Baudouy, Marcel
AU  - Baudouy M
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Germany
TA  - Clin Chem Lab Med
JT  - Clinical chemistry and laboratory medicine
JID - 9806306
RN  - 0LVT1QZ0BA (Homocysteine)
SB  - IM
MH  - Adult
MH  - Female
MH  - Heart Failure/*blood/classification/*pathology
MH  - Homocysteine/*blood
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Survival Rate
EDAT- 2006/06/17 09:00
MHDA- 2006/09/27 09:00
CRDT- 2006/06/17 09:00
PHST- 2006/06/17 09:00 [pubmed]
PHST- 2006/09/27 09:00 [medline]
PHST- 2006/06/17 09:00 [entrez]
AID - 10.1515/CCLM.2006.138 [doi]
PST - ppublish
SO  - Clin Chem Lab Med. 2006;44(7):813-6. doi: 10.1515/CCLM.2006.138.