HOMOCYSTEINE IS NOT AN INDICATOR OF RESTENOSIS RISK AFTER PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY

Year 2000, Volume: 13 Issue: 3, 137 - 142, 03.12.2016

Önder Sirikci Vedat Aytekin Güler Topçu Saide Aytekin Cemsid Demiroğlu Cem'i Demiroğlu

Abstract

Objective: Elevated homocysteine levels have been associated with increased risk of atherosclerotic vascular disease. The possible association of homocysteine with restenosis after percutaneous transluminal coronary angioplasty (PTCA) has not been widely investigated.
Methods: In order to determine if a relationship exists between serum homocysteine levels and restenosis after PTCA, serum homocysteine level were determined in 204 patients who underwent a successful PTCA procedure and stant implantation. The patients were followed with clinical examinations and exercise tests at 1, 3, and 6 months, and a control coronary angiography was performed after 6 months to evaluate restenosis. Homocysteine levels were determined with fluorescence polarization immunoassay.
Results: Of the 146 patients who underwent angiographic evaluation, 57 (39 %) had restenosis, whereas 89 (61 %) did not. The homocysteine distributions were compared in these two groups of patients. Although the
average homocysteine levels were higher in the restenosed group, the difference was not statistically significant.
Conclusion: Because of its wide distribution, serum homocysteine values do not seem to be a useful indicator for the risk of restenosis after PTCA.
Key Words: Homocysteine, Restenosis,
PTCA

References

• Miner SES, Evrovski J, Cole DEC. Clinical chemistry and molecular biology of homocysteine metabolism: An update. Clin Biochem 199 7 ;30:189-201.
• Berwanger CS, Jeremy JY, Stansby Q. Homocysteine and vascular disease. Br J Surg 1995;82:726-731.
• Welch GH, Loscaizo J. Homocysteine and atherothrombosis. Hew Engl J Med 1998:338; 1042-1050.
• Hankey GJ, Eikelboom JW. Homocysteine and vascular disease. Lancet 1999;354:407-413.
• Southern EH, Cruz H, Eink LM, et al. Hyperhomocysteinemia increases intimai hyperplasia in a rat carotid endarterectomy model. J Vase Surg 1998;28:909-918.
• Benoit C, Eurber A, Le Bouil A, et al. Plasma homocysteine is not a predictive factor of restenosis after coronary angioplasty. Arch Mal Coeur Vaiss 1999;92:1457-1460.
• Grüntzig AR, Senning A, Siegenthaler WE. Honoperative dilatation of coronary artery stenosis. H Engl J Med 1979 301:61-68.
• Eiore M, Mitchell J, Doan T, et al. The Abbott
• IMx Automated Benchtop Immunochemistry Analyzer System. Clin Chem
• :34:1726,1732.
• Shipchandler M. Rapid, fully automated measurement of plasma homocysteine with the Abbott IMx Analyzer. Clin Chem 1995;41:991-994.
• Stampfer MJ, Malinow R, Willett WC, et al. A prospective study of plasma homocysteine and risk of myocardial infarction in US physicians. JAMA 1992:268:877-881.
• Wald HJ, Watt HC, Law MR, Weir DG, McPartlin J, Scott JM. Homocysteine and ischemic heart disease: results of a prospective study with implications regarding prevention. Arch Intern Med 1998,158:862-867.
• 4 1
• Önder Sirikci, et al
• Arnesen E, Refsum El, Bonaa KJ, Ueland FM, Forde Oh, hordrehaug JE. Serum total homocysteine and coronary heart disease. Int J Epidemiol 1995;24:704-709.
• Fery 1J, Refsum H, Morris RW, Ebrahlm SB, Ueland FM, Shaper AG. Prospective study of serum total homocysteine concentration and risk of stroke in middle-aged British men. Lancet 1995:346:1395-1398.
• Graham IM, Daly LE, Refsum hM, et al. Plasma homocysteine as a risk factor for vascular disease: the European Concerted Action Project. JAMA 1997;277:1775-1781.
• Boushey CJ, Beresford SAA, Omenn GS, Motulsky AG. A quantitative assessment of plasma homocysteine as a risk factor for vascular disease: probable benefits of increasing folic acid intake. JAMA 1995;274:1049-1057.
• Verhoef P, Hennekens CM, Allen RH, Stabler SP, Willet WC, Stampfer MJ. Plasma total homocysteine and risk of angina pectoris with subsequent coronary artery bypass graft surgery. Am J Cardiol 1997:79:799-801.
• Verhoef P, hennekens Ch, Malinow MR, Kok FJ, Willet WC, Stampfer MJ. A prospective study of plasma homocysteine and risk of ischemic stroke. Stroke 1994;24:1924-1930.
• Evans RW, Shaten J, hempel JD, Cutler JA, Kuller Lh, for the MRFIT Research Group. Homocysteine and risk of cardiovascular disease in the Multiple Risk Factor Intervention Trial. Arterioscler Thromb Vase Biol 1997;17:1947-1953.
• Alfthan G, Pekkanen J, Jauhiainen M, et al.
• Relation of serum homocysteine and lipoprotein(a) concentrations to
• atherosclerotic disease in a prospective Finnish population based study. Atherosclerosis 1994; 106:9-19.
• Folsom AR, hieto J, McGovern PG, et al.
• Prospective study of coronary heart disease incidence in relation to fasting homocysteine, related genetic polymorphisms, and B vitamins: the Atherosclerosis Risk in
• Communities (ARIC) study. Circulation 1998;98:204-210.
• 4