Homocysteine Levels in Patients Undergoing Open-Heart Surgery
Background: The aim of this prospective study was to determine the levels of plasma homocysteine (HCY) in patients who have undergone open-heart surgery for ischemic heart disease (IHD) or nonischemic heart disease (NIHD) and to evaluate whether an association is present between hyperhomocysteinemia and coronary artery disease.
Material and Methods: We investigated prospectively 30 patients who underwent open-heart surgery. Of these patients, 15 had IHD, and 15 had NIHD such as mitral and/or aortic valve disease. The 2 groups were well matched for age, sex, body mass index, and blood pressure. In all patients HCY was assayed by high performance liquid chromatography preoperatively and on the first, second, and third day postoperatively.
Results: The mean age of the patients was 57.2 years in group IHD and 52.6 years in group NIHD. The male:female ratio was 8:7 in group IHD and 7:8 in group NIHD. Of 15 patients in group IHD, 13 had hyperhomocysteinemia and 2 had normal plasma HCY levels. Of 15 patients in NIHD group, 1 had hyperhomocysteinemia and the others had normal plasma HCY levels. Preoperative plasma HCY levels of all patients in the IHD group were significantly lower during all subsequent time periods, whereas preoperative plasma HCY levels in the NIHD group were lower only on the first day post-surgery (P < .05).
Conclusions: Our data suggest that plasma HCY levels in patients with IHD are associated with the development of atherogenesis and coronary artery disease. For this reason, HCY levels should be measured routinely and treated appropriately in patients with risk factors for atherosclerosis.
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