Homocysteine Levels in Patients Undergoing Open-Heart Surgery

  • Necip Becit
  • Sait Kele?
  • Yahya Ünlü
  • Münacettin Ceviz
  • Ahmet Yavuz Balci
  • Hikmet Koçak

Abstract

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.

References

Boushey CJ, Beresford SA, Omenn GS, et al. 1995. A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes. JAMA 274:1049-57.\nBozkurt A, Toyaksi H, Acarturk E, et al. 2003. The effects of hyperhomocysteinemia on the presence, extent, and severity of coronary artery disease. Jpn Heart J 44:357-68.\nChao CL, Tsai HH, Lee CM, et al. 1999. The graded effect of hyperhomocysteinemia on the severity and extent of coronary atherosclerosis. Atherosclerosis 147:379-86.\nEikelboom JW, Lonn E, Genest J Jr, et al. 1999. Homocyst(e)ine and cardiovascular disease: a critical review of the epidemiologic evidence. Ann Intern Med 131:363-75.\nHackam DG, Peterson JC, Spence JD. 2000. What level of plasma homocyst(e)ine should be treated? Effects of vitamin therapy on progression of carotid atherosclerosis in patients with homocyst(e)ine levels above and below 14 $mUmol/L. Am J Hypertens 13:105-10.\nHughes S. 2003. Novel cardiovascular risk factors. J Cardiovasc Nurs 18:131-8.\nLi J, Zhang Y, Yao X, et al. 2002. Effect of homocysteine on the L-arginine/nitric oxide synthase/nitric oxide pathway in human platelets. Heart Vessels 16:46-50.\nMalinow MR, Bostom AG, Krauss RM. 1999. Homocyst(e)ine, diet, and cardiovascular diseases: a statement for healthcare professionals from the Nutrition Committee, American Heart Association. Circulation 99:178-82.\nMayer EL, Jacobsen DW, Robinson K. 1996. Homocysteine and coronary atherosclerosis. J Am Coll Cardiol 27:517-27.\nMilosevic-Tosic M, Borota J. 2002. Hyperhomocysteinemia: a risk factor for development of occlusive vascular diseases. Med Pregl 55:385-91.\nPrasad K. 1999. Homocysteine, a risk factor for cardiovascular disease. Int J Angiol 8:76-86.\nSmith SC, Greenland P, Grundy SM. 2000. AHA Conference Proceedings. Prevention conference V: Beyond secondary prevention: Identifying the high-risk patient for primary prevention: executive summary. American Heart Association. Circulation 101:111-6.\nWilcken DE, Wilcken B. 1997. The natural history of vascular disease in homocystinuria and the effects of treatment. J Inherit Metab Dis 20:295-300.\nWoo KS, Chook P, Lolin YI, et al. 1997. Hyperhomocyst(e)inemia is a risk factor for arterial endothelial dysfunction in humans. Circulation 96:2542-4.\n
Published
2006-09-12
How to Cite
Becit, N., Kele?, S., Ünlü, Y., Ceviz, M., Balci, A., & Koçak, H. (2006). Homocysteine Levels in Patients Undergoing Open-Heart Surgery. The Heart Surgery Forum, 8(1), E66-E68. https://doi.org/10.1532/HSF98.20041147
Section
Articles

Most read articles by the same author(s)