Elevated Plasma Homocysteine Identifies Patients With Chronic Heart Failure at Increased Cardiovascular Risk

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Journal of Cardiac Failure, ISSN: 1071-9164, Vol: 18, Issue: 8, Page: S87

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Iqbal, Naveed S.; Wu, Yuping; Hazen, Stanley; Tang, W.H. Wilson
Elsevier BV
Cardiovascular Diseases; Mathematics
abstract description
Elevated plasma homocysteine (HCY) is a known risk factor for atherosclerotic vascular disease and arterial ischemic events (such as myocardial infarction [MI] or stroke). The prognostic value of HCY levels in contemporary patients with chronic heart failure has not been established. Methods: We measured plasma levels of homocysteine in 733 consecutive stable patients without acute coronary syndrome (cardiac troponin negative), with a history of chronic heart failure, and examined their relationship with incident major adverse cardiac events (MACE 5 death, non-fatal myocardial infarction [MI], stroke) over 3 years. Results: In our study cohort (mean age 63611 years, 65% male, 33% history of MI, 29% diabetes mellitus), median [interquartile range] levels of HCY were 12.1 [9.9-15.4] mmol/L. After adjusting for traditional risk factors and renal function, HCY remained an independent predictor of incident major adverse cardiac events (MACE) at 3-year follow-up (Quartile 4 vs 1, Hazard ratio 1.83 [95% confidence interval 1.15-2.92], p!0.05). Conclusion: Plasma HCY provides independent prognostic value for long-term adverse clinical events in contemporary patients with chronic systolic heart failure.