Hyperhomocysteinaemia is a risk factor for vein graft stenosis

Irvine, C.; Wilson, Y.G.; Currie, I.C.; McGrath, Cpj; Scott, J. Blake; Day, A.; Stansbie, D.; Baird, RN; Lamont, PM

doi:10.1016/s1078-5884(96)80249-8

Cited by 27 publications

(15 citation statements)

References 23 publications

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“…Thrombophilia defects are associated with failed revascularization in patients with peripheral vascular disease; the data suggest that the failure rate may be over three times higher than in patients without such defects1–9. Studies also suggest that hyperhomocysteinaemia is associated with vein graft stenosis10–12. Thrombophilia and hyperhomocysteinaemia appear to be commoner in patients with peripheral vascular disease than in the general population10–23.…”

Section: Introductionmentioning

confidence: 99%

“…Studies also suggest that hyperhomocysteinaemia is associated with vein graft stenosis10–12. Thrombophilia and hyperhomocysteinaemia appear to be commoner in patients with peripheral vascular disease than in the general population10–23. The overall prevalence of thrombophilia defects and hyperhomocysteinaemia are difficult to calculate, as many of the studies were carried out in heterogeneous vascular populations or in early‐onset disease.…”

Section: Introductionmentioning

confidence: 99%

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The prevalence of thrombophilia in patients with symptomatic peripheral vascular disease

Vig

Chitolie

Bevan

et al. 2006

British Journal of Surgery

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The prevalence of thrombophilia in patients with symptomatic peripheral vascular disease

Vig

Chitolie

Bevan

et al. 2006

British Journal of Surgery

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“…Poor run-off of the target vessel as well as technical errors may contribute to the presence of PMI [24]. Interestingly, perioperative hyperhomocysteinemia has been described as a risk factor of medium-term or long-term graft occlusion both after CABG [25] and after peripheral vascular bypass grafting [26]. In our study tHcy levels was associated with the occurrence of PMI in CABG procedures.…”

Section: Discussionmentioning

confidence: 53%

Evaluation of Plasma Homocysteine Levels as a Prognostic Factor for the Occurrence of Perioperative Myocardial Infarction in Coronary Artery Bypass Grafting: A Pilot Study

Anastasiadis¹,

Kambouroglou²,

Karamitsos³

et al. 2008

Vascular Disease Prevention

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Disturbances in homocysteine metabolism may lead to hyperhomocysteinemia. This condition has been associated with vascular atheromatosis leading to coronary artery disease (CAD) as well as myocardial infarction. One hundred patients with CAD who underwent coronary artery bypass grafting (CABG) were enrolled. The study aimed to evaluate cardiac enzymes and electrocardiogram of each patient postoperatively so as to diagnose perioperative myocardial infarction (PMI). An initial decrease of homocysteine immediately postoperatively followed by a progressive increase was recorded. Mild hyperhomocysteinemia preoperatively was more frequent among the patients who developed PMI. A correlation of preoperative homocysteine with troponin in the PMI group was also noted. Homocysteine levels were a prognostic factor for the occurrence of PMI in CABG procedures.

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“…A significant relationship between hyperhomocysteinaemia and vein graft stenosis after infrainguinal bypass grafting was reported [71]. In contrast, another study failed to report similar results [57], although a significant relationship between elevated homocysteine values and myointimal hyperplasia in the grafted vein was demonstrated.…”

Section: Homocysteinementioning

confidence: 99%

The role of established and emerging risk factors in peripheral vascular graft occlusion

Fatourou

Paraskevas

Seifalian

et al. 2007

Expert Opinion on Pharmacotherapy

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Several studies have evaluated the association between established as well as emerging vascular risk factors with peripheral graft occlusion. There is evidence for a link between the risk for graft occlusion and total serum cholesterol, low-density lipoprotein cholesterol and triglyceride levels. The overall effect of smoking shows a 2.35-fold increase in risk of graft failure. Studies involving diabetic patients undergoing peripheral bypass may have failed to detect higher occlusion rates, possibly due to increased morbidity and mortality as well as higher amputation rates even if the graft is patent. Both antiplatelet agents and anticoagulation seem to be effective in the prevention of graft occlusion. Unconvincing data have been published with regards to the effect of hypertension on graft patency. Emerging factors such as fibrinogen, lipoprotein (a), C-reactive protein and homocysteine levels should also be considered when assessing the risk of graft occlusion. More research is needed to prevent graft occlusion due to the obvious clinical relevance, quality of life and cost issues.

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Hyperhomocysteinaemia is a risk factor for vein graft stenosis

Abstract: These results suggest that HHCA is a previously unidentified risk factor for VGS. Patients with HHCA are susceptible to VGS and preoperative investigation would allow identification of patients at risk.

Cited by 27 publications

References 23 publications

The prevalence of thrombophilia in patients with symptomatic peripheral vascular disease

The prevalence of thrombophilia in patients with symptomatic peripheral vascular disease

Evaluation of Plasma Homocysteine Levels as a Prognostic Factor for the Occurrence of Perioperative Myocardial Infarction in Coronary Artery Bypass Grafting: A Pilot Study

The role of established and emerging risk factors in peripheral vascular graft occlusion

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