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Lack of association between baseline plasma homocysteine concentrations and restenosis rates after a first elective percutaneous coronary intervention without stenting
  1. C-K Wong1,*,
  2. C J K Hammett1,
  3. R The2,
  4. J K French1,
  5. W Gao1,
  6. B J Webber3,
  7. J M Elliott1,
  8. A W Hamer1,
  9. J A Ormiston3,
  10. M W I Webster3,
  11. R A H Stewart1,
  12. R V Ameratunga2,
  13. H D White1
  1. 1Cardiovascular Research Unit, Green Lane Hospital, Auckland, New Zealand
  2. 2Department of Immunology, Auckland Hospital, Auckland, New Zealand
  3. 3Cardiac Investigation Rooms, Green Lane Hospital, Auckland, New Zealand
  1. Correspondence to:
    Professor Harvey D White
    Cardiology Department, Auckland City Hospital, Private Bag 92024, Auckland 1030, New Zealand;


Objective: To evaluate the association between baseline homocysteine concentrations and restenosis rates in patients electively undergoing their first percutaneous coronary intervention (PCI) without stenting.

Design: Prospective, single centre, observational study.

Setting and patients: Patients electively undergoing their first PCI without stenting at a tertiary referral centre between 1990 and 1998.

Methods: Blood samples were collected from all patients at baseline and assayed to determine the patients’ homocysteine concentrations. Patients whose PCI was successful underwent repeat angiography at a median of 6.4 (interquartile range 6–6.8) months. Their baseline and follow up angiograms were compared by quantitative coronary angiography to assess the incidence of restenosis. For the analysis, the patients were divided into two groups based on whether their baseline homocysteine concentrations were above or below the median value. These two groups were compared to determine whether there was any association between their baseline homocysteine concentrations and the incidence of restenosis at six months.

Results: 134 patients had a successful first PCI without stenting (involving 200 lesions). At six month angiography, restenosis was observed in 33 patients (49.3%) with baseline homocysteine concentrations above the median value and in 31 patients (46.3%) with concentrations below the median value (p  =  0.74). There was no difference in the percentage of lesions developing restenosis (38 (39.6%) v 40 (38.5%), respectively, p  =  0.87) or late lumen loss (0.40 mm v 0.31 mm, respectively, p  =  0.24). On multivariable analysis, there was no association between homocysteine concentrations and late lumen loss (r  =  −0.11, p  =  0.11) or the percentage diameter stenosis at follow up (r  =  −0.07, p  =  0.32).

Conclusion: Baseline homocysteine concentrations were not associated with six month restenosis rates in patients electively undergoing their first PCI without stenting.

  • FACIT, folate after coronary intervention trial
  • PCI, percutaneous coronary intervention
  • TIMI, thrombolysis in myocardial infarction
  • homocysteine
  • percutaneous coronary intervention
  • restenosis

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  • * Also at the Department of Medical and Surgical Sciences, Dunedin School of Medicine, University of Otago

  • Professor White received partial salary funding from the Green Lane Hospital Research and Educational Fund (Auckland, New Zealand). This work was partly funded by grant 91254 from the New Zealand Lottery Grants Board (Wellington, New Zealand).