Plasma homocysteine and the severity of heart failure in patients with previous myocardial infarction

• Published in: Cardiology journal Vol. 18; no. 1; pp. 55 - 62
• Main Authors: Agoston-Coldea, Lucia, Mocan, Teodora, Gatfosse, Marc, Lupu, Silvia, Dumitrascu, Dan L
• Format: Journal Article
• Language: English
• Published: Poland Wydawnictwo Via Medica 2011
• Subjects: Aged; Biomarkers - blood; Chi-Square Distribution; Chronic Disease; Cross-Sectional Studies; Echocardiography, Doppler; Female; Fluorescence Polarization Immunoassay; Heart attacks; Heart failure; Heart Failure - blood; Heart Failure - diagnostic imaging; Heart Failure - etiology; Heart Failure - physiopathology; Homocysteine; Homocysteine - blood; Humans; Hyperhomocysteinemia - blood; Hyperhomocysteinemia - complications; Hyperhomocysteinemia - diagnosis; Logistic Models; Male; Middle Aged; Myocardial Infarction - blood; Myocardial Infarction - complications; Myocardial Infarction - physiopathology; Odds Ratio; Plasma; Predictive Value of Tests; Risk Assessment; Risk Factors; Severity of Illness Index; Stroke Volume; Up-Regulation; Ventricular Function, Left
• ISSN: 1897-5593; 1897-5593; 1898-018X

Homocysteine is considered to be a risk factor, or an indicator of risk, for the development of cardiovascular disease. Little data is available on its significance in patients with previous myocardial infarction. The aim of our study was to assess the plasma level of homocysteine and its relationship with the severity of heart failure in patients with chronic myocardial infarction.
We studied 144 patients with previous myocardial infarction. Patients were divided into two groups according to the presence or absence of heart failure, as certified by clinical evidence of heart failure and by echocardiographic criteria for left ventricular systolic dysfunction.
Of the patients with prior myocardial infarction (144; 63.6 ± 9.6 years) included in the study, 65 had heart failure. The mean level of homocysteine was significantly higher in the heart failure group (18.9 mmol/L) than in the non-heart failure group (14.1 mmol/L; p ≤ 0.001). Our study demonstrated that there is a statistically significant correlation between homocysteine plasma levels and the severity of heart failure in patients with prior myocardial infarction. Homocysteine levels have proved to become higher with NYHA class progression. A significant cross-sectional correlation has been assessed between homocysteine and tissue Doppler echocardiography parameters.
Increased plasma homocysteine levels independently correlate with the severity of heart failure in patients with chronic myocardial infarction. We suggest that homocysteine can be used in clinical practice as a valuable heart failure risk marker in patients with chronic myocardial infarction.