PMID- 17183715
OWN - NLM
STAT- MEDLINE
DCOM- 20100316
LR  - 20181113
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 1
IP  - 1
DP  - 2006 Dec 20
TI  - Hyperhomocysteinemia and mortality after coronary artery bypass grafting.
PG  - e83
LID - e83
AB  - BACKGROUND: The independent prognostic impact, as well as the possible causal 
      role, of hyperhomocysteinemia (HHcy) in coronary artery disease (CAD) is 
      controversial. No previous study specifically has addressed the relationship 
      between HHcy and mortality after coronary artery bypass grafting (CABG) surgery. 
      The aim of this study is to evaluate the prognostic impact of HHcy after CABG 
      surgery. METHODOLOGY AND PRINCIPAL FINDINGS: We prospectively followed 350 
      patients who underwent elective CABG between May 1996 and May 1999. At baseline, 
      fasting total homocysteine (tHcy) levels were measured in all participants, and a 
      post-methionine loading (PML) test was performed in 77.7% of them (n = 272). 
      After a median follow-up of 58 months, 33 patients (9.4%) had died, 25 because of 
      cardiovascular events. HHcy, defined by levels higher than the 90th percentile 
      (25.2 micromol/L) of the population's distribution, was significantly associated 
      to total and cardiovascular mortality (P = 0.018 [log-rank test 5.57]; P = 0.002 
      [log-rank test 9.76], respectively). The PML test had no prognostic value. After 
      multiple adjustment for other univariate predictors by Cox regression, including 
      statin therapy (the most powerful predictor in uni-/multivariate analyses), 
      high-sensitivity C Reactive Protein (hs-CRP) levels, and all known major genetic 
      (MTHFR 677C-->T polymorphism) and non-genetic (B-group vitamin status and renal 
      function) tHcy determinants, HHcy remained an independent prognostic factor for 
      mortality (HRs: 5.02, 95% CIs 1.88 to 13.42, P = 0.001). CONCLUSIONS: HHcy is an 
      important prognostic marker after CABG, independent of modern drug therapy and 
      biomarkers.
FAU - Girelli, Domenico
AU  - Girelli D
AD  - Department of Clinical and Experimental Medicine, University of Verona, Italy. 
      domenico.girelli@univr.it
FAU - Martinelli, Nicola
AU  - Martinelli N
FAU - Olivieri, Oliviero
AU  - Olivieri O
FAU - Pizzolo, Francesca
AU  - Pizzolo F
FAU - Friso, Simonetta
AU  - Friso S
FAU - Faccini, Giovanni
AU  - Faccini G
FAU - Bozzini, Claudia
AU  - Bozzini C
FAU - Tenuti, Ilaria
AU  - Tenuti I
FAU - Lotto, Valentina
AU  - Lotto V
FAU - Villa, Giuliano
AU  - Villa G
FAU - Guarini, Patrizia
AU  - Guarini P
FAU - Trabetti, Elisabetta
AU  - Trabetti E
FAU - Pignatti, Pier Franco
AU  - Pignatti PF
FAU - Mazzucco, Alessandro
AU  - Mazzucco A
FAU - Corrocher, Roberto
AU  - Corrocher R
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20061220
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0LVT1QZ0BA (Homocysteine)
RN  - EC 1.5.1.20 (Methylenetetrahydrofolate Reductase (NADPH2))
SB  - IM
MH  - Aged
MH  - Coronary Artery Bypass/*mortality
MH  - Coronary Artery Disease/*complications/mortality/*surgery
MH  - Female
MH  - Genotype
MH  - Homocysteine/blood
MH  - Humans
MH  - Hyperhomocysteinemia/blood/*complications/enzymology/genetics
MH  - Italy/epidemiology
MH  - Male
MH  - Methylenetetrahydrofolate Reductase (NADPH2)/genetics
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Prospective Studies
MH  - Risk Factors
PMC - PMC1762373
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2006/12/22 09:00
MHDA- 2006/12/22 09:01
PMCR- 2006/12/20
CRDT- 2006/12/22 09:00
PHST- 2006/10/18 00:00 [received]
PHST- 2006/11/09 00:00 [accepted]
PHST- 2006/12/22 09:00 [pubmed]
PHST- 2006/12/22 09:01 [medline]
PHST- 2006/12/22 09:00 [entrez]
PHST- 2006/12/20 00:00 [pmc-release]
AID - 06-PONE-RA-00253 [pii]
AID - 10.1371/journal.pone.0000083 [doi]
PST - epublish
SO  - PLoS One. 2006 Dec 20;1(1):e83. doi: 10.1371/journal.pone.0000083.