Free Plasma Homocysteine Predicts Recurrent Heart Events

But total homocysteine does not have predictive value in acute coronary syndrome patients

THURSDAY, July 24 (HealthDay News) -- Free plasma homocysteine levels are a significant and independent risk factor for recurrent cardiovascular events for hospitalized patients, while total plasma homocysteine levels have no predictive value, according to an article published in the July 15 issue of The American Journal of Cardiology.

Martijn G.H. van Oijen, of Radboud University Nijmegen Medical Center in Nijmegen, the Netherlands, and colleagues measured total and free plasma homocysteine levels in a cohort of 379 hospitalized patients with acute coronary syndrome. The patients were followed for a median 2.7 years for a composite endpoint of cardiovascular death, myocardial infarction and stroke.

The study found 22 percent of patients experienced a primary endpoint. Adjusted hazard ratios for experiencing a primary endpoint were 2.25 and 1.37, respectively, for elevated free plasma homocysteine and total homocysteine levels, but the total homocysteine was not statistically significant, the researchers report.

"The findings in this study indicate that free homocysteine rather than total homocysteine is a more accurate and independent predictor of new cardiovascular events after acute coronary syndrome," the authors write. "Measurement of free plasma homocysteine levels might be important to identify patients who may need a more aggressive vascular treatment policy, for example, by using angiotensin-converting enzyme inhibitors or statins to obtain a more stringent cholesterol target."

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