Abstract
Background A recent "ex-vivo" study showed that nonvalvular atrial fibrillation (NVAF) is associated with enhanced activity of metalloproteinases at the atrial level, and in animal models homocysteine (Hcy) is able to activate metalloproteinases. The aim of this case-control study was to investigate the association of total Hcy plasma levels, vitamin status (folate, vitamin B6, and vitamin B12), and methylenetetrahydrofolate reductase C677T and CBS 844ins68 polymorphisms with NVAF. Furthermore, the role of these variables in the occurrence of ischemic events was investigated. Methods We studied 310 NVAF patients on oral anticoagulant treatment (168 patients with previous ischemic events and 142 without) and 310 controls. Results Hyperhomocysteinemia (highest quartile) and vitamin B6 deficiency (lowest quartile) were independently associated with NVAF after multivariate analysis (Hcy: odds ratio [OR] 6.40, 95% CI 3.29-12.46; vitamin B6: OR 3.02, 95% CI 1.02-8.95). A significant correlation was found between Hcy levels and left atrial diameter (r = 0.46; P <.001). As shown by multivariate analysis, elevated Hcy levels were an independent risk factor for ischemic complications during NVAF (OR 2.66, 95% CI 1.15-6.20). Conclusions This study demonstrates a significant association of both elevated Hcy levels and low vitamin B6 levels with the presence of NVAF; in addition, it confirms the role of Hcy as a risk factor for ischemic events during NVAF.
| Original language | English |
|---|---|
| Pages (from-to) | 456-461 |
| Number of pages | 6 |
| Journal | American Heart Journal |
| Volume | 148 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Sep 2004 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
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Hyperhomocysteinemia and vitamin B6 deficiency : New risk markers for nonvalvular atrial fibrillation? / Marcucci, Rossella; Betti, Irene; Cecchi, Emanuele; Poli, Daniela; Giusti, Betti; Fedi, Sandra; Lapini, Ilaria; Abbate, Rosanna; Gensini, Gian Franco; Prisco, Domenico.
In: American Heart Journal, Vol. 148, No. 3, 09.2004, p. 456-461.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Hyperhomocysteinemia and vitamin B6 deficiency
T2 - New risk markers for nonvalvular atrial fibrillation?
AU - Marcucci, Rossella
AU - Betti, Irene
AU - Cecchi, Emanuele
AU - Poli, Daniela
AU - Giusti, Betti
AU - Fedi, Sandra
AU - Lapini, Ilaria
AU - Abbate, Rosanna
AU - Gensini, Gian Franco
AU - Prisco, Domenico
PY - 2004/9
Y1 - 2004/9
N2 - Background A recent "ex-vivo" study showed that nonvalvular atrial fibrillation (NVAF) is associated with enhanced activity of metalloproteinases at the atrial level, and in animal models homocysteine (Hcy) is able to activate metalloproteinases. The aim of this case-control study was to investigate the association of total Hcy plasma levels, vitamin status (folate, vitamin B6, and vitamin B12), and methylenetetrahydrofolate reductase C677T and CBS 844ins68 polymorphisms with NVAF. Furthermore, the role of these variables in the occurrence of ischemic events was investigated. Methods We studied 310 NVAF patients on oral anticoagulant treatment (168 patients with previous ischemic events and 142 without) and 310 controls. Results Hyperhomocysteinemia (highest quartile) and vitamin B6 deficiency (lowest quartile) were independently associated with NVAF after multivariate analysis (Hcy: odds ratio [OR] 6.40, 95% CI 3.29-12.46; vitamin B6: OR 3.02, 95% CI 1.02-8.95). A significant correlation was found between Hcy levels and left atrial diameter (r = 0.46; P <.001). As shown by multivariate analysis, elevated Hcy levels were an independent risk factor for ischemic complications during NVAF (OR 2.66, 95% CI 1.15-6.20). Conclusions This study demonstrates a significant association of both elevated Hcy levels and low vitamin B6 levels with the presence of NVAF; in addition, it confirms the role of Hcy as a risk factor for ischemic events during NVAF.
AB - Background A recent "ex-vivo" study showed that nonvalvular atrial fibrillation (NVAF) is associated with enhanced activity of metalloproteinases at the atrial level, and in animal models homocysteine (Hcy) is able to activate metalloproteinases. The aim of this case-control study was to investigate the association of total Hcy plasma levels, vitamin status (folate, vitamin B6, and vitamin B12), and methylenetetrahydrofolate reductase C677T and CBS 844ins68 polymorphisms with NVAF. Furthermore, the role of these variables in the occurrence of ischemic events was investigated. Methods We studied 310 NVAF patients on oral anticoagulant treatment (168 patients with previous ischemic events and 142 without) and 310 controls. Results Hyperhomocysteinemia (highest quartile) and vitamin B6 deficiency (lowest quartile) were independently associated with NVAF after multivariate analysis (Hcy: odds ratio [OR] 6.40, 95% CI 3.29-12.46; vitamin B6: OR 3.02, 95% CI 1.02-8.95). A significant correlation was found between Hcy levels and left atrial diameter (r = 0.46; P <.001). As shown by multivariate analysis, elevated Hcy levels were an independent risk factor for ischemic complications during NVAF (OR 2.66, 95% CI 1.15-6.20). Conclusions This study demonstrates a significant association of both elevated Hcy levels and low vitamin B6 levels with the presence of NVAF; in addition, it confirms the role of Hcy as a risk factor for ischemic events during NVAF.
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U2 - 10.1016/j.ahj.2004.03.017
DO - 10.1016/j.ahj.2004.03.017
M3 - Article
C2 - 15389232
AN - SCOPUS:4644335244
VL - 148
SP - 456
EP - 461
JO - American Heart Journal
JF - American Heart Journal
SN - 0002-8703
IS - 3
ER -