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Relation of homocysteinemia to contrast-induced nephropathy in patients undergoing percutaneous coronary intervention.

 Seung Jun Kim  ;  Donghoon Choi  ;  Tae-Hyun Yoo  ;  Kyu Hun Choi  ;  Shin-Wook Kang  ;  Yangsoo Jang  ;  Myeong-Ki Hong  ;  Byung-Keuk Kim  ;  Seung Hyeok Han  ;  Jung-Sun Kim  ;  Young-Guk Ko 
 American Journal of Cardiology, Vol.108(8) : 1086-1091, 2011 
Journal Title
 American Journal of Cardiology 
Issue Date
Hyperhomocysteinemia induces oxidative stress and endothelial dysfunction, which share the proposed pathophysiologic mechanisms of contrast-induced nephropathy (CIN). However, no study has investigated the relation between hyperhomocysteinemia and CIN. The aim of the present study was to evaluate the effects of hyperhomocysteinemia on CIN in patients undergoing percutaneous coronary intervention. This was an observational cohort study that included 572 patients who underwent percutaneous coronary intervention. CIN was defined as an absolute ≥0.5 mg/dl or a relative ≥25% increase in the serum creatinine level at 48 hours after the procedure. The incidence of CIN was significantly greater in patients in the third homocysteine tertile (from lowest to highest, 4.7%, 7.3%, and 24.2%, p <0.001). Furthermore, the homocysteine levels were significantly greater in patients with CIN than in those without CIN (16.9 ± 4.9 vs 13.5 ± 4.2 μmol/L, p <0.001). In multiple logistic regression models, hyperhomocysteinemia was an independent risk factor for CIN (per the SD change in the plasma homocysteine level [4.44 μmol/L], odds ratio 1.70, 95% confidence interval 1.07 to 2.71, p = 0.025) after adjusting for major risk factors such as age, diabetes, and baseline cardiac and renal function. In subgroup analyses according to diabetes, acute coronary syndrome, or baseline estimated glomerular filtration rate, significant, graded associations were found between the homocysteine level and the incidence of CIN. In conclusion, hyperhomocysteinemia is independently associated with a greater risk of CIN in patients undergoing percutaneous coronary intervention.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
강신욱(Kang, Shin Wook) ; 고영국(Ko, Young Guk) ; 김병극(Kim, Byeong Keuk) ; 김승준(Kim, Seung Jun) ; 김중선(Kim, Jung Sun) ; 유태현(Yoo, Tae Hyun) ; 장양수(Jang, Yang Soo) ; 최규헌(Choi, Kyu Hun) ; 최동훈(Choi, Dong Hoon) ; 한승혁(Han, Seung Hyeok) ; 홍명기(Hong, Myeong Ki)
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