scholarly journals Homocysteine: Chemistry, metabolism and roles in pathophysiology processes

2003 ◽  
Vol 22 (2) ◽  
pp. 127-140 ◽  
Author(s):  
Dusko Mirkovic ◽  
Nada Majkic-Singh ◽  
Svetlana Ignjatovic

In 1962, 30 years after chemical structure discovery of homocysteine, Carson and Neil reported work in which they described cases of two young people with severe mental retardation and high homocysteinuria. In 1975 McCully emphasized the association between homocysteinuria and thrombus-occlusive vascular changes. Period 1991-98, is the time of very extensive comparative studies, with aim of establishing links between premature coronary artery disease and high homocysteine level in plasma. These results in a whole show that biochemical findings of a mild increase of homocysteine plasma levels in span of 15-45 mmol/L, are independent risk factor for premature coronary artery disease appearance. So far mechanism of direct homociysteine uninfluenced on endothelial vascular vessels cells, or influence of any other factor, which play role in methionine-homocysteine-cysteine path (vitamins B6, B12, folic acid) are not strictly elucidated.

2013 ◽  
Vol 3 (4) ◽  
pp. 246-253 ◽  
Author(s):  
Sara Zand ◽  
Akbar Shafiee ◽  
Mohammadali Boroumand ◽  
Arash Jalali ◽  
Younes Nozari

2018 ◽  
Vol 118 (12) ◽  
pp. 2162-2170 ◽  
Author(s):  
Kamilla Steensig ◽  
Kevin Olesen ◽  
Troels Thim ◽  
Jens Nielsen ◽  
Svend Jensen ◽  
...  

Background Patients with atrial fibrillation (AF) have an increased risk of ischaemic stroke. The risk can be predicted by the CHA2DS2-VASc score, in which the vascular component refers to previous myocardial infarction, peripheral artery disease and aortic plaque, whereas coronary artery disease (CAD) is not included. Objectives This article explores whether CAD per se or extent provides independent prognostic information of future stroke among patients with AF. Materials and Methods Consecutive patients with AF and coronary angiography performed between 2004 and 2012 were included. The endpoint was a composite of ischaemic stroke, transient ischaemic attack and systemic embolism. The risk of ischaemic events was estimated according to the presence and extent of CAD. Incidence rate ratios (IRR) were calculated in reference to patients without CAD and adjusted for parameters included in the CHA2DS2-VASc score and treatment with anti-platelet agents and/or oral anticoagulants. Results Of 96,430 patients undergoing coronary angiography, 12,690 had AF. Among patients with AF, 7,533 (59.4%) had CAD. Mean follow-up was 3 years. While presence of CAD was an independent risk factor for the composite endpoint (adjusted IRR, 1.25; 1.06–1.47), extent of CAD defined as 1-, 2-, 3- or diffuse vessel disease did not add additional independent risk information. Conclusion Presence, but not extent, of CAD was an independent risk factor of the composite thromboembolic endpoint beyond the components already included in the CHA2DS2-VASc score. Consequently, we suggest that significant angiographically proven CAD should be included in the vascular disease criterion in the CHA2DS2-VASc score.


2009 ◽  
Vol 16 (02) ◽  
pp. 192-197
Author(s):  
FIDA MUHAMMAD ◽  
Nadeem Hayat Mallick, ◽  
ABDUL REHMAN ABID ◽  
AJAZ AHMAD ◽  
Shahid Imran

Objectives: This study was designed to evaluate the pattern of clinical presentation, risk factors and angiographic findingsin young males presenting with acute myocardial infarction (AMI).Materials and methodsThis cross-sectional descriptive study wasconducted at the Cardiology Department, Punjab Institute of Cardiology, Lahore from May 2005 till February 2006. After fulfilling the inclusioncriteria 200 male patients <40 years with coronary artery disease (CAD) were studied. Results: Mean age of the study population was31.5±9.2 years with an age range of 31 to 40 years. Most common risk factor was smoking present in 60% patients. Family history ofischemic heart disease (IHD) was present in 44.5% patients, hyperlipidemia in 35.5% patients, hypertension in 25.5% and diabetes mellitusin 17.5% of patients.Common mode of clinical presentation was AMI 42.5% patients. Left anterior descending (LAD) was diseased in 73.5%,followed by Left Circumflex (LCx) 51% and Right Coronary Artery (RCA) in 39% patients. Left Main Stem (LMS) disease occurred in 9.5%patients. Good left ventricular (LV) systolic function was observed in 38%, moderate LV systolic function in 34% and poor LV systolic functionin 14.5% patients. Conclusion: Patients with premature coronary artery disease have unheralded acute onset of symptoms. Smoking isthe most common risk factor. Young patients have single vessel CAD with frequent involvement of LAD and commonly have good leftventricular systolic function.


2021 ◽  
Vol 27 ◽  
Author(s):  
Emmanuel P. Vardas ◽  
Evangelos Oikonomou ◽  
Gerasimos Siasos ◽  
Panagiotis Theofilis ◽  
Polychronis Dilaveris ◽  
...  

: Potential sex-related differences in the periprocedural and long-term postprocedural outcomes of coronary angioplasty in patients with stable coronary artery disease have been studied thoroughly over the last few decades, to determine whether female sex should be regarded as an independent risk factor that affects clinical outcomes. Based on a significant number of observational studies and meta-analyses, sex has not yet emerged as an independent risk factor for either mortality or major cardiac and cerebrovascular events, despite the fact that in the early 1980s, for several reasons, female sex was associated with unfavourable outcomes. Therefore, it remains debatable whether female sex should be considered as an independent risk factor for periprocedural and long-term bleeding events. The pharmacological and technological advancements that support current coronary angioplasty procedures, as well as the non-delayed treatment of coronary artery disease in females have certainly lessened the outcome differences between the two sexes. However, females show fluctuations in blood coagulability through their lifetime and higher prevalence of bleeding episodes associated with the antithrombotic treatment, following transcatheter coronary reperfusion interventions. In conclusion, the clinical results of percutaneous coronary intervention in patients with stable coronary artery disease, during the periprocedural and long-term postprocedural periods, appear to show no significant differences between the two sexes, except for bleeding rates, which seem to be higher in females, a difference that mandates further systematic research.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Sonoda ◽  
D Kanda ◽  
K Anzaki ◽  
R Arikawa ◽  
A Tokushige ◽  
...  

Abstract Background In patients undergo PCI for coronary artery disease, target lesion calcification is associated with major cardiac events. Malnutrition is the important factor to cause frailty and sarcopenia which affect prognosis of cardiovascular diseases. However, the relationship between morphology in target lesions and malnutrition in patients undergo PCI is still uncertain. Purpose The aim of the present study was to investigate how malnutrition affects prognosis of stable angina patients underwent PCI and morphology in target lesions. Methods The subject was 206 consecutive stable angina patients undergone successful PCI using second-generation drug eluting stents and intravascular ultrasound (IVUS). The study patients were divided into two groups based on malnutrition or non-malnutrition. Nutritional status was assessed by Geriatric Nutritional Risk Index (GNRI), and patients with GNRI&lt;92 at admission were defined as malnutrition group (MG). We investigated the association between malnutrition on admission and outcome, and morphology in target lesions assessed by IVUS. Target lesion morphology were divided into moderate/severe calcified group and none/mild calcified group. Results All-cause death and MACCE (major cardiovascular and cerebrovascular events) ≤3 years after PCI were 15 cases (7%) and 33 cases (16%). MG had higher rate of all-cause death (20 vs. 6%, p=0.001) and MACCE (37 vs. 10%, p&lt;0.001) than those of non-MG. Kaplan Meier analysis elucidated that survival rate was significantly lower in MG compared to that in non-MG (p&lt;0.001). As a result of cox proportional hazards analysis, all-cause death was associated with age [hazard ratio (HR): 1.05, 95% confidence interval (CI): 1.01–1.10, p=0.006)], hs-CRP (HR: 1.03, 95% CI: 1.03–1.12, p&lt;0.001), hemodialysis (HR: 2.25, 95% CI: 1.08–4.68, p=0.029), left ventricular ejection fraction (LVEF) (HR: 0.97, 95% CI: 0.95–0.99, p=0.017) and malnutrition (HR: 4.38, 95% CI: 2.11–9.09, p&lt;0.001) in the univariate analysis. Similarly, cox proportional hazards analysis revealed that age (HR: 1.04, 95% CI: 1.01–1.07, p=0.018), hs-CRP (HR: 1.08, 95% CI: 1.03–1.11, p&lt;0.001), hemodialysis (HR: 2.68, 95% CI: 1.45–4.94, p=0.002), LVEF (HR: 0.97, 95% CI: 0.95–0.99, p=0.002) and malnutrition (HR: 4.14, 95% CI: 2.23–7.67, p&lt;0.001) were significantly associated with MACCE. Multivariate analysis for all-cause death and MACCE revealed that malnutrition was an independent risk factor (HR: 3.47, 95% CI: 1.52–7.94, p=0.003, HR: 3.76, 95% CI: 1.87–7.58, p&lt;0.001). Furthermore, MG was significantly associated with moderate/severe target calcified lesions assessed by IVUS compared to those of patients in non-MG (67 vs. 27%, p&lt;0.001) regardless with or without hemodialysis. Conclusions Malnutrition was a crucial independent risk factor for stable angina patients who underwent PCI and was significantly associated with moderate/severe target calcified lesions. Funding Acknowledgement Type of funding source: None


1992 ◽  
Vol 13 (10) ◽  
pp. 1311-1315 ◽  
Author(s):  
E. D. GRECH ◽  
D. R. RAMSDALE ◽  
C. L. BRAY ◽  
E. B. FARAGHER

2016 ◽  
Vol 71 (6) ◽  
pp. 685-689
Author(s):  
Anke Nguyen ◽  
Heath Adams ◽  
Julian Gin ◽  
Natalie Yap ◽  
Amy Wilson-O’brien ◽  
...  

1994 ◽  
Vol 74 (4) ◽  
pp. 398-399 ◽  
Author(s):  
Andrew D. Krahn ◽  
Jure Manfreda ◽  
Robert B. Tate ◽  
Francis A.L. Mathewson ◽  
T.Edward Cuddy

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