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Original ArticleOpen Access
Homocysteine and Restenosis After Percutaneous Coronary Intervention
Mahanonda N 
,
Lolekha P ,
Leowattana W ,
Pokum S ,
Kangkagate C
,
Lolekha P ,
Leowattana W ,
Pokum S ,
Kangkagate C PAKORN LOLEKHA, M.D.**,
SASIKANT POKUM, B.Sc.
***,
Numerous clinical studies in Western and Asian countries suggest that individuals with
elevated blood levels of homocysteine have an increased risk of atherosclerosis, myocardial infarc-
tion, cerebral infarction, and deep vein thrombosis. Homocysteine is also known to induce both
atherogenic and thrombogenic mediators in cultured vascular cells so that homocysteine may
influence the damage of endothelial cells, promote smooth muscle cell growth, induce atherogenic
mediatorsเธ— and thrombus formation after coronary angioplasty. The association between homocysteine
and restenosis after percutaneous coronary intervention (PCI) has been discussed. In this study, the
relationship between plasma homocysteine levels and restenosis after PCI to investigate whether
plasma homocysteine levels may be a predictor of restenosis after PCI was examined. One hundred
consecutive patients who underwent successful PCI were enrolled and plasma homocysteine level
was measured in all patients prior to PCI. Plasma for homocysteine level was obtained in 99 of 100
patients who had angioplasty. The mean plasma homocysteine concentration in the enrolled patients
was 13.61เธ‘6.04 jlmol/L. The minimum and maximum of plasma homocysteine were 4.40 jlmol/L
and 50.00 IJ.mol/L, respectively. In healthy subjects, the normal reference range of homocysteine
level is 5-15 jlmol!L However, recent data suggest that some patients may be at increased cardio-
vascular and cerebrovascular risk at levels as low as 12
~tmol!L.
For this reason, both cut off points
of homocysteine level
~
15 jlmo1/L
or~
12 jlmol!L to identify the high homocysteine level group
were used. Of 99 patients, high homocysteine level
(~
15 jlmol/L) was established in 9 patients
with restenosis
versus
20 patients without restenosis.
If
the cut off point of homocysteine level
~
12 jlmol/L was used, high homocysteine level was established in 14 patients with restenosis
versus
Vol. 84 Suppl 3 HOMOCYSTEINE AND RESTENOSIS AFTER PERCUTANEOUS CORONARY INTERVENTION S637
39 patients without restenosis. From both cut off points of homocysteine level, there was no cor-
relation between plasma homocysteine level and the restenosis group. (p>0.05).
Key word : Plasma Homocysteine, Restenosis, Percutaneous Coronary Intervention
SASIKANT POKUM, B.Sc.
***,
Numerous clinical studies in Western and Asian countries suggest that individuals with
elevated blood levels of homocysteine have an increased risk of atherosclerosis, myocardial infarc-
tion, cerebral infarction, and deep vein thrombosis. Homocysteine is also known to induce both
atherogenic and thrombogenic mediators in cultured vascular cells so that homocysteine may
influence the damage of endothelial cells, promote smooth muscle cell growth, induce atherogenic
mediatorsเธ— and thrombus formation after coronary angioplasty. The association between homocysteine
and restenosis after percutaneous coronary intervention (PCI) has been discussed. In this study, the
relationship between plasma homocysteine levels and restenosis after PCI to investigate whether
plasma homocysteine levels may be a predictor of restenosis after PCI was examined. One hundred
consecutive patients who underwent successful PCI were enrolled and plasma homocysteine level
was measured in all patients prior to PCI. Plasma for homocysteine level was obtained in 99 of 100
patients who had angioplasty. The mean plasma homocysteine concentration in the enrolled patients
was 13.61เธ‘6.04 jlmol/L. The minimum and maximum of plasma homocysteine were 4.40 jlmol/L
and 50.00 IJ.mol/L, respectively. In healthy subjects, the normal reference range of homocysteine
level is 5-15 jlmol!L However, recent data suggest that some patients may be at increased cardio-
vascular and cerebrovascular risk at levels as low as 12
~tmol!L.
For this reason, both cut off points
of homocysteine level
~
15 jlmo1/L
or~
12 jlmol!L to identify the high homocysteine level group
were used. Of 99 patients, high homocysteine level
(~
15 jlmol/L) was established in 9 patients
with restenosis
versus
20 patients without restenosis.
If
the cut off point of homocysteine level
~
12 jlmol/L was used, high homocysteine level was established in 14 patients with restenosis
versus
Vol. 84 Suppl 3 HOMOCYSTEINE AND RESTENOSIS AFTER PERCUTANEOUS CORONARY INTERVENTION S637
39 patients without restenosis. From both cut off points of homocysteine level, there was no cor-
relation between plasma homocysteine level and the restenosis group. (p>0.05).
Key word : Plasma Homocysteine, Restenosis, Percutaneous Coronary Intervention
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