PLASMA TOTAL HOMOCYSTEINE (HCY) AS ADDITIONAL CARDIOVASCULAR RISK FACTOR IN PATIENTS WITH INTESTINAL TRANSPLANTATION G Bianchi, E Pompignoli, A Lauro, G Passerini, R Chianese, A Pinna, M Zoli Dipartimento di Medicina Interna, Cardioangiologia, Epatologia and Centro Trapianti, Università di Bologna Transplanted patients show an increased rate of cardiovascular events, probably due to metabolic changes induced by immunosuppressive therapy. Among cardiovascular risk factors, high plasma homocysteine (HiHCY) has an indepedent role. No data are available about HiHCY prevalence in subjects with intestinal transplant (ITX) as effect of immunosuppressive drugs. 21 subjects, ageing 24 to 57, with ITX dating 6 months or more (median 29 months; range 6-69) were tested in 79 determinations. All patients received Tacrolimus (FK) as major immunosuppressive agent. Total Hcy was assayed on chromatography. Routine laboratory data, history of diabetes, hypertension, dyslipidemia, overweight and cardiovascular events, occurred over 6 months from ITX, were recorded. Additional events were recorded during the study period. ITX subjects showed increased Hcy levels (median 19 mmol/L, range 8.6 – 80.6). 75% of ITX patients had Hcy >15 µmol/L. The same prevalence was observed for patients with mild kidney failure (creatinine levels above 1.7 mg/dl). Patients with normal and increased creatinine did not differ significantly for HCY or prevalence of HiHCY, and no relation was present between the two variables. Total homocysteine plasma levels were related to tacrolimus serum levels (R = 0.305, P < 0.01). One heart ischemic problem was observed in a patient with severe kidney failure; two patients had problems in abdominal and/or peripheral venous districts, with HiHCY and some signs of the metabolic syndrome. HiHCY is frequently found in ITX patients. Its role in the genesis of cardiovascular events and the usefulness of a HiHCY lowering therapy remains to verify.
Homocysteine and cardiovascular risk in patients with intestinal transplantation / G. Bianchi; E. Pompignoli; A. Lauro; G. Passerini; R. Chianese; V. Mantovani; A.D. Pinna; M. Zoli. - In: INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS. - ISSN 0391-3988. - STAMPA. - 28:(2005), pp. 930-930. (Intervento presentato al convegno XXXII ESAO (European Association for Artificial Organs) Congress tenutosi a Bologna nel 5-8 ottobre 2005.).
Homocysteine and cardiovascular risk in patients with intestinal transplantation.
BIANCHI, GIAMPAOLO;PASSERINI, GIORGIA;CHIANESE, RAFFAELA;PINNA, ANTONIO DANIELE;ZOLI, MARCO
2005
Abstract
PLASMA TOTAL HOMOCYSTEINE (HCY) AS ADDITIONAL CARDIOVASCULAR RISK FACTOR IN PATIENTS WITH INTESTINAL TRANSPLANTATION G Bianchi, E Pompignoli, A Lauro, G Passerini, R Chianese, A Pinna, M Zoli Dipartimento di Medicina Interna, Cardioangiologia, Epatologia and Centro Trapianti, Università di Bologna Transplanted patients show an increased rate of cardiovascular events, probably due to metabolic changes induced by immunosuppressive therapy. Among cardiovascular risk factors, high plasma homocysteine (HiHCY) has an indepedent role. No data are available about HiHCY prevalence in subjects with intestinal transplant (ITX) as effect of immunosuppressive drugs. 21 subjects, ageing 24 to 57, with ITX dating 6 months or more (median 29 months; range 6-69) were tested in 79 determinations. All patients received Tacrolimus (FK) as major immunosuppressive agent. Total Hcy was assayed on chromatography. Routine laboratory data, history of diabetes, hypertension, dyslipidemia, overweight and cardiovascular events, occurred over 6 months from ITX, were recorded. Additional events were recorded during the study period. ITX subjects showed increased Hcy levels (median 19 mmol/L, range 8.6 – 80.6). 75% of ITX patients had Hcy >15 µmol/L. The same prevalence was observed for patients with mild kidney failure (creatinine levels above 1.7 mg/dl). Patients with normal and increased creatinine did not differ significantly for HCY or prevalence of HiHCY, and no relation was present between the two variables. Total homocysteine plasma levels were related to tacrolimus serum levels (R = 0.305, P < 0.01). One heart ischemic problem was observed in a patient with severe kidney failure; two patients had problems in abdominal and/or peripheral venous districts, with HiHCY and some signs of the metabolic syndrome. HiHCY is frequently found in ITX patients. Its role in the genesis of cardiovascular events and the usefulness of a HiHCY lowering therapy remains to verify.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
