PMID- 34131779
OWN - NLM
STAT- MEDLINE
DCOM- 20220208
LR  - 20220218
IS  - 1615-2573 (Electronic)
IS  - 0910-8327 (Print)
IS  - 0910-8327 (Linking)
VI  - 36
IP  - 12
DP  - 2021 Dec
TI  - Impact of homocysteine levels on mortality risk in patients with chronic 
      limb-threatening ischemia undergoing revascularization.
PG  - 1825-1829
LID - 10.1007/s00380-021-01877-0 [doi]
AB  - The current study aimed to reveal the clinical impact of plasma homocysteine 
      levels in chronic limb-threatening ischemia (CLTI) patients undergoing 
      revascularization. This was a sub-analysis of a prospective multicenter registry 
      of CLTI patients, named the Surgical reconstruction versus Peripheral 
      INtervention in pAtients with critical limb isCHemia (SPINACH) study. The current 
      analysis included 192 non-dialysis-dependent CLTI patients who underwent 
      revascularization for CLTI, and whose plasma homocysteine levels at baseline were 
      available. The association of clinical characteristics with homocysteine 
      levels was evaluated with the linear regression model. The association 
      of homocysteine levels with the mortality risk was investigated using the Cox 
      proportional hazards regression model. Cystatin C-based estimated glomerular 
      filtration rate (eGFR) was independently associated with log-transformed 
      homocysteine levels; the adjusted standardized regression coefficient (95% 
      confidence interval) was - 0.432 (- 0.657 to - 0.253; P < 0.001). Homocysteine 
      levels were significantly associated with the mortality risk in the univariate 
      model (P = 0.017); the unadjusted hazard ratio was 1.71 (1.13-2.50) per twofold 
      increase. The association was significantly attenuated when adjusted for cystatin 
      C-based eGFR (P < 0.001); the hazard ratio adjusted for cystatin C-based eGFR was 
      1.28 (0.80-1.90; P = 0.29). An apparent association of homocysteine levels with 
      an increased risk of mortality could be explained by renal dysfunction. Future 
      studies will be needed to validate the current findings.
CI  - (c) 2021. The Author(s).
FAU - Takahara, Mitsuyoshi
AU  - Takahara M
AD  - Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 
      2-2 Yamadaoka, Suita, 565-0871, Japan.
AD  - Department of Diabetes Care Medicine, Osaka University Graduate School of 
      Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan.
FAU - Iida, Osamu
AU  - Iida O
AD  - Cardiovascular Center, Kansai Rosai Hospital, 3-1-69 Inabaso, Amagasaki, Hyogo, 
      660-8511, Japan. iida.osa@gmail.com.
FAU - Soga, Yoshimitsu
AU  - Soga Y
AD  - Department of Cardiology, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-ku, 
      Kitakyushu, 802-0001, Japan.
FAU - Kodama, Akio
AU  - Kodama A
AD  - Division of Vascular Surgery, Department of Surgery, Nagoya University Graduate 
      School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
FAU - Terashi, Hiroto
AU  - Terashi H
AD  - Department of Plastic Surgery, Kobe University Graduate School of Medicine, 
      7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
FAU - Azuma, Nobuyoshi
AU  - Azuma N
AD  - Department of Vascular Surgery, Asahikawa Medical University, 2-1 
      Midorigaoka-higashi, Asahikawa, 078-8510, Japan.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20210615
PL  - Japan
TA  - Heart Vessels
JT  - Heart and vessels
JID - 8511258
RN  - 0 (Cystatin C)
RN  - 0LVT1QZ0BA (Homocysteine)
SB  - IM
MH  - Chronic Disease
MH  - *Chronic Limb-Threatening Ischemia
MH  - Cystatin C
MH  - *Endovascular Procedures
MH  - Homocysteine
MH  - Humans
MH  - Ischemia/diagnosis/surgery
MH  - Limb Salvage
MH  - Peripheral Arterial Disease/diagnosis/surgery
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
PMC - PMC8556169
OTO - NOTNLM
OT  - Chronic limb-threatening ischemia
OT  - Cystatin C
OT  - Homocysteine levels
OT  - Mortality risk
OT  - Renal function
COIS- The authors declare that they have no conflict of interest.
EDAT- 2021/06/17 06:00
MHDA- 2022/02/09 06:00
PMCR- 2021/06/15
CRDT- 2021/06/16 06:55
PHST- 2021/03/25 00:00 [received]
PHST- 2021/05/14 00:00 [accepted]
PHST- 2021/06/17 06:00 [pubmed]
PHST- 2022/02/09 06:00 [medline]
PHST- 2021/06/16 06:55 [entrez]
PHST- 2021/06/15 00:00 [pmc-release]
AID - 10.1007/s00380-021-01877-0 [pii]
AID - 1877 [pii]
AID - 10.1007/s00380-021-01877-0 [doi]
PST - ppublish
SO  - Heart Vessels. 2021 Dec;36(12):1825-1829. doi: 10.1007/s00380-021-01877-0. Epub 
      2021 Jun 15.