Serum homocysteine levels and mortality in outpatients with or without coronary artery disease: an observational study

Acevedo, Mónica; Pearce, Gregory L.; Jacobsen, Donald W.; Minor, Stephen; Sprecher, Dennis L.

doi:10.1016/s0002-9343(03)00123-2

Cited by 8 publications

(7 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Six studies 7, 9, 11, 13, 14, 16 were included in the dose-response meta-analysis. The result showed a linear relationship between Hcy levels and all-cause mortality ( p non-linearity = 0.255), by using a restricted cubic spline model.…”

Section: Resultsmentioning

confidence: 99%

“…In this meta-analysis, subgroup analyses were further conducted to investigate the potential inter-study heterogeneity and examine the robustness of primary results 31 . We divided the subgroups as follows: geographical location (Asia 16–18 , North America 11, 12 , or Europe 9, 10, 13–15, 32 ), sex (male 10, 16, 17 or female 10, 16 ), duration of follow-up (<7 years 7, 9, 11, 14, 15, 17 or ≥7 years 10, 12, 13, 16, 18 ), sample size (<1000 13–15 or ≥1000 7, 9–12, 16–18 ), fasting status (yes 7, 11, 14, 15 or no 12, 13, 16 ), and NOS score (≤7 7, 11, 17 or >7 9, 10, 12–16, 18 ). We also performed analyses stratified by whether the studies had adjusted for potential confounding factors, including smoking, alcohol consumption, BMI, physical activity, history of CVD, history of diabetes, and serum vitamin B12/folate.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Association between Homocysteine Levels and All-cause Mortality: A Dose-Response Meta-Analysis of Prospective Studies

Fan

Zhang

Zhong

2017

Sci Rep

View full text Add to dashboard Cite

Plasma homocysteine (Hcy) levels may be associated with all-cause mortality risk. However, the results of this association are conflicting and the dose-response relationship between them has not been clearly defined. In this meta-analysis, we conducted a systematic literature search of the PubMed, Embase, Web of Science and Cochrane Library for the relevant articles dated up to February 2017. Pooled relative risks (RRs) and corresponding 95% confidence intervals (CIs) were calculated to evaluate the estimates, and the dose-response relationship was estimated using a restricted cubic spline model. Eleven prospective studies (4,110 deaths among 27,737 individuals) were included. The summary RR of all-cause mortality for the highest Hcy category vs. the lowest Hcy category was 1.80 (95% CI: 1.51, 2.14) with the random effects model. In dose-response meta-analysis, Hcy levels were significantly associated with all-cause mortality risk in a linear fashion (p nonlinearity = 0.255), and the risk of all-cause mortality increased by 33.6% for each 5 µmol/L increase in Hcy levels (RR = 1.336, 95% CI: 1.254–1.422, p < 0.001). Findings from this dose-response meta-analysis suggest that Hcy levels are linearly and positively associated with risk of all-cause mortality.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Association between Homocysteine Levels and All-cause Mortality: A Dose-Response Meta-Analysis of Prospective Studies

Fan

Zhang

Zhong

2017

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Most of the studies consisted of large, healthy populations [6] or patients whose homocysteine levels were measured at the time of coronary angiography [7], or in convalescent state [8] and who were followed for cardiovascular events. Few studies have examined total mortality as the primary end point after an acute coronary syndrome [9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Early determination of homocysteine levels in acute coronary syndromes, is it an independent prognostic factor?

Fácila

Núñez

Bertomeu

et al. 2005

International Journal of Cardiology

View full text Add to dashboard Cite

“…Many clinical studies have identified homocysteine as a significant and independent risk factor for cardiovascular diseases ( 20 , 21 ). Moreover, a significant association between hyperhomocysteinemia and cardiovascular events has been indicated in several large-scale prospective studies ( 9 , 10 , 22 , 23 ). In addition, it has been reported that the Chinese population has a higher serum homocysteine level compared with the western populations ( 24 ).…”

Section: Discussionmentioning

confidence: 97%

“…Epidemiological studies show that serum homocysteine concentration is associated with stroke, coronary heart disease, peripheral artery disease, and venous thrombosis ( 8 ). Prospective researches have demons-trated that homocysteine can predict mortality and other cardiovascular events in subjects with or without coronary artery disease ( 9 , 10 ). Currently, homocysteine is identified as an intensive and independent risk factor and predictor for cardiovascular diseases ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

Homocysteine enhances the predictive value of the GRACE risk score in patients with ST-elevation myocardial infarction

Fan

Wang²,

Wan³

et al. 2017

Anatol J Cardiol

View full text Add to dashboard Cite

Objective:The present study aims to investigate whether the addition of homocysteine level to the Global Registry of Acute Coronary Events (GRACE) risk score enhances its predictive value for clinical outcomes in ST-elevation myocardial infarction (STEMI).Methods:A total of 1143 consecutive patients with STEMI were included in this prospective cohort study. Homocysteine was detected, and the GRACE score was calculated. The predictive power of the GRACE score alone or combined with homocysteine was assessed by the receiver operating characteristic (ROC) analysis, methods of net reclassification improvement (NRI) and integrated discrimination improvement (IDI).Results:During a median follow-up period of 36.7 months, 271 (23.7%) patients reached the clinical endpoints. It showed that the GRACE score and homocysteine could independently predict all-cause death [GRACE: HR=1.031 (1.024–1.039), p<0.001; homocysteine: HR=1.023 (1.018–1.028), p<0.001] and MACE [GRACE: HR=1.008 (1.005–1.011), p<0.001; homocysteine: HR=1.022 (1.018–1.025), p<0.001]. When they were used in combination to assess the clinical outcomes, the area under the ROC curve significantly increased from 0.786 to 0.884 (95% CI=0.067–0.128, Z=6.307, p<0.001) for all-cause death and from 0.678 to 0.759 (95% CI=0.055–0.108, Z=5.943, p<0.001) for MACE. The addition of homocysteine to the GRACE model improved NRI (all-cause death: 0.575, p<0.001; MACE: 0.621, p=0.008) and IDI (all-cause death: 0.083, p<0.001; MACE: 0.130, p=0.016), indicating effective discrimination and reclassification.Conclusion:Both the GRACE score and homocysteine are significant and independent predictors for clinical outcomes in patients with STEMI. A combination of them can develop a more predominant prediction for clinical outcomes in these patients.

show abstract

Serum homocysteine levels and mortality in outpatients with or without coronary artery disease: an observational study

Cited by 8 publications

References 23 publications

Association between Homocysteine Levels and All-cause Mortality: A Dose-Response Meta-Analysis of Prospective Studies

Association between Homocysteine Levels and All-cause Mortality: A Dose-Response Meta-Analysis of Prospective Studies

Early determination of homocysteine levels in acute coronary syndromes, is it an independent prognostic factor?

Homocysteine enhances the predictive value of the GRACE risk score in patients with ST-elevation myocardial infarction

Contact Info

Product

Resources

About