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Plasma homocysteine and restenosis after femoropopliteal angioplasty


Kovacevic, T; Van Der Loo, B; Amann-Vesti, B R; Rousson, V; Koppensteiner, R (2004). Plasma homocysteine and restenosis after femoropopliteal angioplasty. Journal of Endovascular Therapy, 11(3):302-309.

Abstract

Purpose: To assess the relationship between plasma homocysteine levels and restenosis after femoropopliteal percutaneous transluminal angioplasty.Methods: Over a 10-month period, 128 consecutive, symptomatic patients (72 men; median age 70 years) having successful femoropopliteal angioplasty for atherosclerotic occlusive disease were prospectively enrolled in the study. Plasma homocysteine levels were determined the day before the procedure. The primary endpoint was restenosis >50%, documented by duplex sonography, at up to 12 months' follow-up. Cox proportional hazards analysis was used to determine the risk of restenosis in relation to pretreatment homocysteine levels.Results: The restenosis rate at 12 months was 46%. Median baseline plasma homocysteine levels were not different in patients with and without restenosis (15.4 versus 16.7 micromol/L, p=0.30). Compared to patients with homocysteine levels </=14 micromol/L (lower tertile, n=43), the hazard ratio of incident restenosis was 0.75 (95% CI 0.40 to 1.40) in patients with homocysteine levels from 14.1 to 19.6 micromol/L (middle tertile, n=42) and 0.64 (95% CI 0.33 to 1.22) in patients with homocysteine levels >/=19.7 micromol/L (upper tertile, n=42) (p=0.38). Multivariate analysis showed that lesion length (p<0.0001) and lack of hypertension (p=0.0013) were associated with restenosis.Conclusions: Elevated plasma homocysteine levels are not associated with restenosis after femoropopliteal angioplasty. Therefore, plasma homocysteine cannot be considered as an important risk factor influencing the outcome after initially successful angioplasty in femoropopliteal arteries.

Abstract

Purpose: To assess the relationship between plasma homocysteine levels and restenosis after femoropopliteal percutaneous transluminal angioplasty.Methods: Over a 10-month period, 128 consecutive, symptomatic patients (72 men; median age 70 years) having successful femoropopliteal angioplasty for atherosclerotic occlusive disease were prospectively enrolled in the study. Plasma homocysteine levels were determined the day before the procedure. The primary endpoint was restenosis >50%, documented by duplex sonography, at up to 12 months' follow-up. Cox proportional hazards analysis was used to determine the risk of restenosis in relation to pretreatment homocysteine levels.Results: The restenosis rate at 12 months was 46%. Median baseline plasma homocysteine levels were not different in patients with and without restenosis (15.4 versus 16.7 micromol/L, p=0.30). Compared to patients with homocysteine levels </=14 micromol/L (lower tertile, n=43), the hazard ratio of incident restenosis was 0.75 (95% CI 0.40 to 1.40) in patients with homocysteine levels from 14.1 to 19.6 micromol/L (middle tertile, n=42) and 0.64 (95% CI 0.33 to 1.22) in patients with homocysteine levels >/=19.7 micromol/L (upper tertile, n=42) (p=0.38). Multivariate analysis showed that lesion length (p<0.0001) and lack of hypertension (p=0.0013) were associated with restenosis.Conclusions: Elevated plasma homocysteine levels are not associated with restenosis after femoropopliteal angioplasty. Therefore, plasma homocysteine cannot be considered as an important risk factor influencing the outcome after initially successful angioplasty in femoropopliteal arteries.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
Dewey Decimal Classification:610 Medicine & health
Date:2004
Deposited On:27 Jun 2009 12:53
Last Modified:21 Nov 2017 14:14
Publisher:International Society of Endovascular Specialists
ISSN:1526-6028
Publisher DOI:https://doi.org/10.1583/03-1086.1
PubMed ID:15174910

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