Homocysteine and Restenosis After Percutaneous Coro- nary Intervention
NITHI MAHANONDA, M.D.*, WATT ANA LEOW ATTANA, M.D.***, CHARUWAN KANGKAGATE, B.Sc. * PAKORN LOLEKHA, M.D.**, SASIKANT POKUM, B.Sc. ***,
Affiliation : * Her Majesty Cardiac Center, ** Division of Cardiology, Department of Medicine, *** Division of Clinical Chemistry, Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Numerous clinical studies in Western and Asian countries suggest that individuals with elevated blood levels of homocysteine have an increased risk of atherosclerosis, myocardial infarc- tion, cerebral infarction, and deep vein thrombosis. Homocysteine is also known to induce both atherogenic and thrombogenic mediators in cultured vascular cells so that homocysteine may influence the damage of endothelial cells, promote smooth muscle cell growth, induce atherogenic mediators· and thrombus formation after coronary angioplasty. The association between homocysteine and restenosis after percutaneous coronary intervention (PCI) has been discussed. In this study, the relationship between plasma homocysteine levels and restenosis after PCI to investigate whether plasma homocysteine levels may be a predictor of restenosis after PCI was examined. One hundred consecutive patients who underwent successful PCI were enrolled and plasma homocysteine level was measured in all patients prior to PCI. Plasma for homocysteine level was obtained in 99 of 100 patients who had angioplasty. The mean plasma homocysteine concentration in the enrolled patients was 13.61±6.04 jlmol/L. The minimum and maximum of plasma homocysteine were 4.40 jlmol/L and 50.00 IJ.mol/L, respectively. In healthy subjects, the normal reference range of homocysteine level is 5-15 jlmol!L However, recent data suggest that some patients may be at increased cardio- vascular and cerebrovascular risk at levels as low as 12 ~tmol!L. For this reason, both cut off points of homocysteine level ~ 15 jlmo1/L or~ 12 jlmol!L to identify the high homocysteine level group were used. Of 99 patients, high homocysteine level (~ 15 jlmol/L) was established in 9 patients with restenosis versus 20 patients without restenosis. If the cut off point of homocysteine level ~ 12 jlmol/L was used, high homocysteine level was established in 14 patients with restenosis versus 39 patients without restenosis. From both cut off points of homocysteine level, there was no cor- relation between plasma homocysteine level and the restenosis group. (p>0.05).
Keywords : Plasma Homocysteine, Restenosis, Percutaneous Coronary Intervention
