HYPERHOMOCYSTEINEMIA IN PATIENTS WITH PULMONARY EMBOLISM
2010
Investigation of hyperhomocysteinemia (HHcy) as an important risk factor for
pulmonary thromboembolism (PTE), which represents a most dangerous
consequence of a unique phenomenon of venous thromboembolism which still
suffers from sometimes conflicting or inadequately clarified results. The
role of homocysteine in the clinical manifestation of this life-threatening
disease and its treatment (in which any further information may be decisive)
requires detailed examination. The purpose of this study is to determine the
differences in HHcy incidence and homocysteinemia levels between patients
with PTE and healthy persons. The study enrolled 70 patients with PTE and 50
healthy persons. Homocysteine was measured using the HPLC method with
fluorescent detection and HHcy was defined as homocysteinemia above 12
μmol/L. Statistical analyses included chi-square and Mann Whitney U tests.
The median homocysteinemia value was significantly higher (p=0.017) in the
patients (12.10 μmol/L) than in the controls (10.35 μmol/L). The comparison
of HHcy incidence between the patients (51.5%) and controls (30%) revealed a
significant difference (p=0.021). In patients, homocysteinemia was
significantly higher (p=0.002) in men (14.05μmol/L) than in women (10.01
μmol/L). HHcy was present in 67.6% of men with PTE, which was significantly
higher (p=0.006) than the incidence in women with PTE (33.3%). Healthy males
had significantly higher (p=0.001) homocysteinemia (12.54 μmol/L) than
healthy females (9.4 μmol/L). A significant difference (p=0.031) was observed
between the incidences of HHcy in healthy males (44.0%) and healthy females
(16.0%). We conclude that the incidence of hyperhomocysteinemia and
homocysteinemia are significantly higher in all the patients compared with
the healthy persons, as well as in both healthy males and males with PTE
compared with healthy females and female patients. This indicates that HHcy
findings in PE are likely to have a clinical importance.
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