PMID- 32322661
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220414
IS  - 2352-9067 (Print)
IS  - 2352-9067 (Electronic)
IS  - 2352-9067 (Linking)
VI  - 28
DP  - 2020 Jun
TI  - Elevated plasma homocysteine levels are associated with impaired peripheral 
      microvascular vasomotor response.
PG  - 100515
LID - 10.1016/j.ijcha.2020.100515 [doi]
LID - 100515
AB  - BACKGROUND: Hyperhomocysteinemia (HHcy) has been proposed as an important 
      cardiovascular risk factor (cRF). However, little is known about the association 
      between plasma homocysteine levels and peripheral microvascular endothelial 
      dysfunction (PMED), which is an integrated index of vascular health. METHODS: 
      This cross-sectional and retrospective cohort study included patients who 
      underwent non-invasive PMED assessment using reactive hyperemia peripheral 
      arterial tonometry (RH-PAT). The association between HHcy and PMED, and its 
      impact on MACE (all-cause mortality and atherosclerotic cardiovascular events) 
      was investigated. RESULTS: A total of 257 patients were enrolled 
      (HHcy > 10.0 micromol/L, N = 51; lower levels of homocysteine [LHcy] </= 10 micromol/L, 
      N = 206). Patients with HHcy were older, predominantly males, and with more 
      comorbidities than patients with LHcy (p < 0.05 for all). RH-PAT index was lower 
      in patients with HHcy versus LHcy (p = 0.01). A significant association between 
      HHcy and PMED was observed in older (>/=60 years), obese (>/=30 kg/m(2)), 
      present/past smokers and hypertensive patients. HHcy was significantly associated 
      with PMED even after adjusting for other cRF and B-vitamins supplementation. HHcy 
      was associated with an increased risk of MACE with a hazard ratio of 3.65 (95% CI 
      1.41-9.48, p = 0.01) and an adjusted hazard ratio of 2.44 (95% CI 0.91-6.51, 
      p = 0.08) after adjustment for age (>/=60 years). CONCLUSION: HHcy was 
      independently associated with PMED after adjusting for cRF and B-vitamins 
      supplementation. Thus, the link between homocysteine and MACE could be mediated 
      by endothelial dysfunction, and will require further clarification with future 
      studies.
CI  - (c) 2020 The Authors.
FAU - Toya, Takumi
AU  - Toya T
AD  - Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, 
      Rochester, MN, USA.
AD  - Division of Cardiology, National Defense Medical College, 3-2 Namiki, Tokorozawa, 
      Saitama, Japan.
FAU - Sara, Jaskanwal D
AU  - Sara JD
AD  - Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, 
      Rochester, MN, USA.
FAU - Lerman, Ben
AU  - Lerman B
AD  - School of Medicine, St. George's University, St George's, West Indies, Grenada.
FAU - Ahmad, Ali
AU  - Ahmad A
AD  - Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, 
      Rochester, MN, USA.
FAU - Taher, Riad
AU  - Taher R
AD  - Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, 
      Rochester, MN, USA.
FAU - Godo, Shigeo
AU  - Godo S
AD  - Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, 
      Rochester, MN, USA.
FAU - Corban, Michel T
AU  - Corban MT
AD  - Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, 
      Rochester, MN, USA.
FAU - Lerman, Lilach O
AU  - Lerman LO
AD  - Division of Nephrology and Hypertension, Mayo Clinic, 200 First Street SW, 
      Rochester, MN, USA.
FAU - Lerman, Amir
AU  - Lerman A
AD  - Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, 
      Rochester, MN, USA.
LA  - eng
PT  - Journal Article
DEP - 20200417
PL  - Ireland
TA  - Int J Cardiol Heart Vasc
JT  - International journal of cardiology. Heart & vasculature
JID - 101649525
PMC - PMC7171522
OTO - NOTNLM
OT  - ADMA, asymmetric dimethylarginine
OT  - B-vitamins, vitamin B6 and vitamin B12
OT  - BH4, tetrahydrobiopterin
OT  - BMI, body mass index
OT  - CI, confidence interval
OT  - Endothelial dysfunction
OT  - Homocysteine
OT  - MACE, major adverse cardiovascular events
OT  - OR, odds ratio
OT  - PMED, peripheral microvascular endothelial dysfunction
OT  - RH-PAT index
OT  - RH-PAT, reactive hyperemia peripheral arterial tonometry
COIS- Amir Lerman declared consulting for Itamar Medical.
EDAT- 2020/04/24 06:00
MHDA- 2020/04/24 06:01
PMCR- 2020/04/17
CRDT- 2020/04/24 06:00
PHST- 2020/01/28 00:00 [received]
PHST- 2020/04/07 00:00 [revised]
PHST- 2020/04/08 00:00 [accepted]
PHST- 2020/04/24 06:00 [entrez]
PHST- 2020/04/24 06:00 [pubmed]
PHST- 2020/04/24 06:01 [medline]
PHST- 2020/04/17 00:00 [pmc-release]
AID - S2352-9067(20)30074-9 [pii]
AID - 100515 [pii]
AID - 10.1016/j.ijcha.2020.100515 [doi]
PST - epublish
SO  - Int J Cardiol Heart Vasc. 2020 Apr 17;28:100515. doi: 
      10.1016/j.ijcha.2020.100515. eCollection 2020 Jun.