Hyperhomocysteinemia and recurrent carotid stenosis

doi:10.1186/1471-2261-8-1

BMC Cardiovascular Disorders

Volume 8

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Research article

Hyperhomocysteinemia and recurrent carotid stenosis

Renata Hillenbrand¹^* , Andreas Hillenbrand²^* , Florian Liewald³ and Julian Zimmermann³

¹Department of Vascular and Thoracic Surgery, University of Ulm, Ulm, German

²Department of General, Visceral and Transplantation Surgery, University of Ulm, Ulm, Germany

³Department of Vascular and Thoracic Surgery, Clinic Esslingen; Esslingen a. N; Germany

author email corresponding author email* Contributed equally

BMC Cardiovascular Disorders 2008, 8:1doi:10.1186/1471-2261-8-1


Published:	17 January 2008

Abstract

Background

Hyperhomocysteinemia has been identified as a potential risk for atherosclerotic disease in epidemiologic studies. This study investigates the impact of elevated serum homocysteine on restenosis after carotid endarterectomy (CEA).

Methods

In a retrospective study, we compared fasting plasma homocysteine levels of 51 patients who developed restenosis during an eight year period after CEA with 45 patients who did not develop restenosis. Restenosis was defined as at least 50% stenosis and was assessed by applying a routine duplex scan follow up investigation. Patients with restenosis were divided into a group with early restenosis (between 3 and 18 months postoperative, a total of 39 patients) and late restenosis (19 and more months; a total of 12 patients).

Results

The groups were controlled for age, sex, and risk factors such as diabetes, nicotine abuse, weight, hypertension, and hyperlipidemia. Patients with restenosis had a significant lower mean homocysteine level (9.11 μmol/L; range: 3.23 μmol/L to 26.49 μmol/L) compared to patients without restenosis (11.01 μmol/L; range: 5.09 μmol/L to 23.29 μmol/L; p = 0.03).

Mean homocysteine level in patients with early restenosis was 8.88 μmol/L (range: 3.23–26.49 μmol/L) and 9.86 μmol/L (range 4.44–19.06 μmol/L) in late restenosis (p = 0.50).

Conclusion

The finding suggests that high plasma homocysteine concentrations do not play a significant role in the development of restenosis following CEA.