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Serum homocysteine concentration as an indicator of survival in patients with acute coronary syndromes
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2000 (English)In: Archnet-IJAR : International Journal of Architectural Research, ISSN 1994-6961, E-ISSN 1938-7806, Vol. 160, no 12, 1834-1840 p.Article in journal (Refereed) Published
Abstract [en]

Background Circulating homocysteine levels are predictive of survival in patients with stable coronary artery disease. The prognostic value of serum homocysteine levels, obtained in the acute phase in patients with myocardial infarction or unstable angina, is unknown. Objective To test the hypothesis that circulating homocysteine levels, obtained during the first 24 hours following hospital admission in patients with acute coronary syndromes, are predictive of long-term mortality. Methods To test this hypothesis we performed a prospective inception cohort study at a teaching hospital in Gothenburg, Sweden. A total of 579 patients (179 women and 400 men; median age, 67 years) were included (Q-wave myocardial infarction in 163 patients, non– Q-wave myocardial infarction in 210 patients, unstable angina pectoris in 206 patients). Main Outcome Measure All-cause mortality. Results During a median follow-up of 628 days, 65 patients died. The serum homocysteine level (mean [SD]) was significantly lower in long-term survivors (n=514) than in nonsurvivors (n=65) (12.3 [7.0] vs 14.3 [5.9] µmol/L; P=.003). The relative risk (all-cause mortality) for patients with homocysteine levels in the upper quartile was 2.4 (95% confidence interval, 1.5-4.0) compared with that of patients in the 3 lower quartiles. After adjustment for relevant confounders, the relative risk estimate remained significant (relative risk=1.69; 95% confidence interval, 1.02-2.80). In a stepwise model the homocysteine level provided prognostic information additional to that of patient age, diabetes mellitus, and diuretic usage prior to hospital admission (P=.03). Conclusion The serum homocysteine level on hospital admission is an independent predictor of long-term survival in patients with acute coronary syndromes.

Place, publisher, year, edition, pages
American Medical Association , 2000. Vol. 160, no 12, 1834-1840 p.
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Medical and Health Sciences
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URN: urn:nbn:se:hb:diva-7913Local ID: 2320/8659OAI: oai:DiVA.org:hb-7913DiVA: diva2:888795
Available from: 2015-12-22 Created: 2015-12-22 Last updated: 2017-10-04Bibliographically approved

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Herlitz, Johan

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