Association of mild hyperhomocysteinemia with cardiac graft vascular disease

被引:43
作者
Ambrosi, P [1 ]
Garçon, D
Riberi, A
Habib, G
Barlatier, A
Kreitmann, B
Rolland, PH
Bouvenot, G
Luccioni, R
Métras, D
机构
[1] Hop Enfants La Timone, Cardiac Transplant Unit, F-13385 Marseille, France
[2] Hop Enfants La Timone, Dept Biochem, F-13385 Marseille, France
[3] Fac Med Marseille, Lab Physiol & Pharmacokinet, F-13005 Marseille, France
[4] Fac Med Marseille, Lab Therapeut, F-13005 Marseille, France
关键词
homocysteine; cardiac transplantation; coronary artery; atherothrombosis; creatinine;
D O I
10.1016/S0021-9150(98)00029-X
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
In non-transplant patients mild hyperhomocysteinemia is an independent risk factor for vascular disease. The aim of this study was to determine whether hyperhomocysteinemia is associated with graft vascular disease. Fasting total plasma homocysteine was assessed in 18 patients with graft vasculopathy and 18 transplanted patients without graft vasculopathy matched for age, sex and the time since transplant. All were on cyclosporin. Graft vasculopathy was defined at coronary angiography as stenoses greater than or equal to 25%, or aneurysms, We found that hyperhomocysteinemia (greater than or equal to 15 mu mol/l) is common among transplanted heart recipients and significantly more frequent in the patients with graft vasculopathy (17/18 versus 11/18). Accordingly, the mean homocysteinemia was significantly higher in the group with graft vasculopathy (23.6 +/- 7.8 versus 16.9 +/- 7.1 mu mol/l, P = 0.01). The elevation of homocysteine plasma levels in the heart transplant recipients has probably multiple causes. The main cause seems to be renal failure. Additional causes could be azathioprine treatment or genetic polymorphisms. These results suggest that besides the immunological factors, homocysteine can play an additional role in the pathogenesis of graft vascular disease. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.
引用
收藏
页码:347 / 350
页数:4
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