Plasma total homocysteine and cardiovascular risk in patients submitted to liver transplantation

Giampaolo Bianchi, Francesco Nicolino, Giorgia Passerini, Gian Luca Grazi, Paola Zappoli, Romina Graziani, Annalisa Berzigotti, Raffaela Chianese, Vilma Mantovani, Antonio Daniele Pinna, Marco Zoli

Research output: Contribution to journalArticle

Abstract

Patients submitted to orthotopic liver transplantation (OLT) show an increased rate of cardiovascular events. OLT subjects have high homocysteine (Hcy) levels, but no data are available on the association of Hcy with cardiovascular events. In a cross-sectional analysis, 230 subjects were studied at least 6 months after OLT (159 on cyclosporine, 71 on tacrolimus). Routine laboratory data and total Hcy were recorded, as well as the history of diabetes, hypertension, dyslipidemia, and overweight. Cardiovascular events occurring in a follow-up of 2-36 months were registered. OLT subjects had higher-than-normal Hcy (median 16.7 μmol/L, range 6.1-171.8) without difference between the 2 immunosuppressive agents. The prevalence of Hcy >15 μmol/L was also similar, and significantly correlated with creatinine levels. A total of 28 arterial events occurred in 25 patients during follow-up (11 in coronary arteries 10 in peripheral arteries, and 7 in splanchnic arteries). Deep vein thromboses occurred in 2 patients, and splanchnic vein thromboses in 4 patients. Cardiovascular events were frequently associated to high Hcy and hypertension. Cox regression analysis showed that high Hcy was significantly associated with arterial events. The risk of any arterial event, coronary artery or peripheral artery event increased by nearly 10% for any increase in Hcy of 5 μmol/L. In conclusion, high Hcy may be involved in the pathogenesis of cardiovascular events in OLT patients. The usefulness of Hcy-lowering therapy remains to be verified.

Original languageEnglish
Pages (from-to)105-111
Number of pages7
JournalLiver Transplantation
Volume12
Issue number1
DOIs
Publication statusPublished - Jan 2006

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Homocysteine
Liver Transplantation
Viscera
Arteries
Coronary Vessels
Hypertension
Tacrolimus
Immunosuppressive Agents
Dyslipidemias
Venous Thrombosis
Cyclosporine
Veins
Creatinine
Thrombosis
Cross-Sectional Studies
History
Regression Analysis

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Bianchi, G., Nicolino, F., Passerini, G., Grazi, G. L., Zappoli, P., Graziani, R., ... Zoli, M. (2006). Plasma total homocysteine and cardiovascular risk in patients submitted to liver transplantation. Liver Transplantation, 12(1), 105-111. https://doi.org/10.1002/lt.20586

Plasma total homocysteine and cardiovascular risk in patients submitted to liver transplantation. / Bianchi, Giampaolo; Nicolino, Francesco; Passerini, Giorgia; Grazi, Gian Luca; Zappoli, Paola; Graziani, Romina; Berzigotti, Annalisa; Chianese, Raffaela; Mantovani, Vilma; Pinna, Antonio Daniele; Zoli, Marco.

In: Liver Transplantation, Vol. 12, No. 1, 01.2006, p. 105-111.

Research output: Contribution to journalArticle

Bianchi, G, Nicolino, F, Passerini, G, Grazi, GL, Zappoli, P, Graziani, R, Berzigotti, A, Chianese, R, Mantovani, V, Pinna, AD & Zoli, M 2006, 'Plasma total homocysteine and cardiovascular risk in patients submitted to liver transplantation', Liver Transplantation, vol. 12, no. 1, pp. 105-111. https://doi.org/10.1002/lt.20586
Bianchi, Giampaolo ; Nicolino, Francesco ; Passerini, Giorgia ; Grazi, Gian Luca ; Zappoli, Paola ; Graziani, Romina ; Berzigotti, Annalisa ; Chianese, Raffaela ; Mantovani, Vilma ; Pinna, Antonio Daniele ; Zoli, Marco. / Plasma total homocysteine and cardiovascular risk in patients submitted to liver transplantation. In: Liver Transplantation. 2006 ; Vol. 12, No. 1. pp. 105-111.
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