Elevated homocysteine levels in patients with heart failure

Abstract

Background:Elevated homocysteine (Hcy) levels showed increasing significance as the predisposing factor for the pathogenesis of atherosclerotic sequelae, including cardiovascular mortality, coronary artery disease, and stroke. There is increasing evidence linking plasma Hcy levels and heart failure (HF). The association between the elevated level of plasma Hcy and HF was examined by meta-analysis and systematic review in this study.Methods:The PubMed and ScienceDirect databases until April 2020 were utilized to collect previous literature on plasma Hcy levels and the potential relation to HF. The pooled effects were evaluated depending on standardized mean differences (SMDs) with 95% confidence intervals (CIs), and the calculation was performed using Stata 12 software. Potential sources of heterogeneity were assessed with subgroup analysis and sensitivity analysis.Results:A total of 12 research projects including 5506 subjects were selected. For pooled effect, the results confirmed that patients with HF had higher Hcy levels than the control subjects (SMD,1.148 and 95%CI, [0.715, 1.581]). Based on the classification of New York Heart Association (NYHA), the Hcy levels for the group of NYHA I or II (SMD, 1.484 and 95% CI, [0.442, 2.527]) and the group of NYHA III or IV (SMD, 3.361 and 95% CI, [1.902, 4.820]) were significantly increased compared to controls, while the increase was more intensive for the group of NYHA III or IV. Subgroup analyses revealed similar results.Conclusion:Our meta-analysis identified that plasma Hcy levels were significantly elevated in HF patients compared to control subjects, which is positively related to the advancement of NYHA class.

Homocysteine metabolism as the target for predictive medical approach, disease prevention, prognosis, and treatments tailored to the person

“…Jin et al (2021) evaluated the correlation between elevated plasma Hcy and heart failure subjects. This meta-analysis revealed significantly elevated plasma Hcy levels in patients with heart failure compared to the control individuals [76]. Another retrospective study evaluated the predictive role of HHcy for obstructive coronary artery disease (CAD) in an Asian population.…”

“…CVD includes several pathologies from which the coronary heart disease, cerebrovascular disease, or rheumatic heart disease have the highest incidence. More than 80% of CVD deaths are attributed to heart attacks and strokes, and approximately one-third of these deaths occur prematurely in people under 70 years of age [76]. Conventional risk factors of CVDs such as dyslipidemia, hypertension, smoking, or diabetes mellitus do not fully clarify all CVD events and deaths.…”

Nutritional biomarkers and heart failure requiring hospitalization in patients with type 2 diabetes: the SURDIAGENE cohort

“…However, we found that homocysteine concentration was associated with all-cause death, even when adjusting on age, sex, and, notably, renal and cardiac biomarkers. Of interest, a recent meta-analysis found that homocysteine concentrations were higher in patients with HF compared with those without [30]. Our results suggest against a strong effect of folate consumption regarding HF.…”

Plasma homocysteine levels and risk of congestive heart failure or cardiomyopathy: A Mendelian randomization study

“…Clinical studies suggested that hyperhomocysteinemia (i.e., fasting plasma homocysteine > 10 µmol/l) is related to the incidence and severity of chronic heart failure (40,41). A recent meta-analysis drew similar conclusions (42). Cardiomyopathy is the most frequent genetic cause of congestive heart failure owing to untreated and uncontrolled systolic dysfunction at a later stage.…”