The impact of circulating total homocysteine levels on long-term cardiovascular mortality in patients with acute coronary syndromes

The impact of circulating total homocysteine levels on long-term cardiovascular mortality in patients with acute coronary syndromes
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DOI:
10.1016/j.ijcard.2007.02.011
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发表时间:
2008-03-14
影响因子:
3.5
通讯作者:
Argyrakis, Spyros K.
Argyrakis, Spyros K.
中科院分区:
医学2区
文献类型:
--
作者:
Foussas, Stefanos G.;Zairis, Michael N.;Argyrakis, Spyros K.

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工作背景:在ST段抬高型心肌梗死(STEMI)或非ST段抬高型急性冠脉综合征患者中,评价循环总同型半胱氨酸(tHcy)水平对长期心血管死亡率的可能独立影响方法:共458名STEMI和476名NSTE-ACS患者,他们分别在指数疼痛的前12小时和24小时内连续出现。根据呈现时的循环tHcy水平的三分位数将每个群组划分。早期(30天)和晚期结果:ST段抬高型心肌梗死(STEMI)患者tHcy三分位数之间30天心血管死亡风险无差异(第一、第二和第三个三分位数分别为7.2%、8.5%和12.4%; P趋势=0.3)或NSTE-ACS(第一、第二和第三个三分位数分别为3.1%、3.8%和5.7%; P趋势=0.5)。在STEMI患者中,tHcy水平较高三分位数的患者晚期(从31天到5年)心血管死亡的未校正风险显著高于其他两个三分位数的患者(第一、第二和第三个三分位数分别为23.4%、27.9%和41.8%; P趋势
Background: To evaluate the possible independent impact of circulating total homocysteine (tHcy) levels on long-term cardiovascular mortality, in patients with either ST-segment elevation myocardial infarction (STEMI), or non-ST-segment elevation acute coronary syndromes (NSTE-ACS).Methods: A total of 458 STEMI and 476 NSTE-ACS patients who presented consecutively, within the first 12 and 24 h of index pain respectively were studied. Each cohort was divided according to tertiles of circulating tHcy levels upon presentation. Early (30 days) and late (31 days through 5 years) cardiovascular mortality was the predefined study endpoint.Results: There was no difference in the risk of 30-day cardiovascular death among the tertiles of tHcy in patients with STEMI (7.2%, 8.5% and 12.4% for the first, second and third tertiles respectively; P-trend=0.3) or NSTE-ACS (3.1%, 3.8% and 5.7% for the first, second and third tertiles respectively; P-trend=0.5). Patients in the upper tHcy tertile were at significantly higher unadjusted risk of late (from 31 days trough 5 years) cardiovascular death than those in the other two tertiles in STEMI (23.4%, 27.9% and 41.8% for the first, second and third tertiles respectively; P-trend