Homocysteine, the cholesterol of the 21st century. Impact of hyperhomocysteinemia on patency and amputation-free survival after intervention for critical limb ischemia

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists
Helen M Heneghan, Sherif Sultan

Abstract

To assess the prevalence of hyperhomocysteinemia and determine any correlation to the clinical and technical outcome of peripheral arterial revascularization for critical limb ischemia (CLI). Between October 1, 2002, and December 31, 2006, 953 revascularization procedures were performed for CLI in a high-volume tertiary referral vascular/endovascular unit. Fasting plasma homocysteine was accurately measured preoperatively in 225 patients (124 men; mean age 75.8 years, range 45-98), who formed the basis for the study. All patients had multilevel disease (TASC II C and D lesions), and 73% had single vessel runoff. Composite primary endpoints included primary, assisted primary, and secondary patency; amputation-free survival; and all-cause mortality. The prevalence of hyperhomocysteinemia was 30% [69 patients (36 men; mean age 78.2 years, range 53-93)]; most (88%) of the patients showed a mild elevation in homocysteine (13-20 micromol/L). Patients with hyperhomocysteinemia had significantly lower primary, assisted primary, and secondary patency rates at all intervals to 36 months (3.3%, 10.8%, and 11.2%, respectively; p<0.001) after the intervention compared to patients with normal homocysteine levels (50.8%, 54.6%, and 57.1%, res...Continue Reading

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Citations

Dec 6, 2012·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Peadar S WatersSherif Sultan
Feb 12, 2015·Clinical Science·Smriti Murali KrishnaJonathan Golledge
Apr 24, 2014·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Sherif Sultan, Niamh Hynes
Jan 10, 2019·The American Journal of Clinical Nutrition·Yaren YuXiping Xu
Aug 1, 2009·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Sherif Sultan, Niamh Hynes
Nov 19, 2009·The Annals of Pharmacotherapy·James M BackesPatrick M Moriarty
Jul 10, 2020·Arteriosclerosis, Thrombosis, and Vascular Biology·Bram KremersArina Ten Cate-Hoek

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