PROGNOSTIC SIGNIFICANCE OF THE HOMOCYSTEINE LEVELS IN THE INCIDENCE OF MAJOR CARDIOVASCULAR EVENTS

Objective: Introduction: The role of homocysteine to the cardiovascular outcome is not fully understood, as also and its importance, concerning the major cardiovascular events in the general population. Aim: The aim of the study was the correlation of the homocysteine levels with the incidence of major cardiovascular events as also the prognostic significance of homocysteine in hypertensive patients or normotensives. Design and method: We studied 140 hypertensive patients (female 52.2%), treated or newly diagnosed untreated, as also normotensives of median age: 57.2 +-13,0 years, without any known cardiovascular disease and with mean office systolic/diastolic arterial blood pressure (S/DBPo): 152.2±19.3/91.6±13.1 mmHg, mean office heart rate (HRo): 75.8±12.1 bpm, median body mass index (BMI): 28.1±5 kg/m2 and median waist circumference (WC) 96.1±12.1 cm. The median follow up time was 7,5 years. The homocysteine levels were recorded before and during the study (mean concentration: 14,5±8,4) Major cardiovascular events (MCE): heart attack, unstable angina, transient or not stroke, CABG, heart attack, were recorded. We assessed the prognostic value of the homocysteine levels by using Cox proportional hazard model analysis. Results: 35 major cardiovascular events were recorded by the end of the study and the analysis showed that the homocysteine levels were an independent prognostic factor for the major cardiovascular events. (HR: 1,054 95%cl: 1,025-1,084 p value <0.001) Prognostic value of the homocysteine levels for MCE Hazard ratio 95% Confidence Intervals P value homocysteine (mol/L) 1,05 1,025 – 1,084 0,000 Conclusions: The homocysteine levels have a statistic significant prognostic value for the major cardiovascular events in hypertensives or normotensives.