Use of plasma homocysteine concentration to predict the risk of all-cause death in adults with diastolic dysfunction in a community – A 13-year follow-up study
Date Issued
2012
Date
2012
Author(s)
Luo, Jing-Ling
Abstract
Background：Hypermohocysteinemia was found highly associated with systolic heart failure and it could also predict progosis. We conducted a cohort study to find whether hyperhomocysteinemia was associated with poor prognosis in diastolic dysfunction patients.
Method：The Chin-Shan Community Cardiovascular Cohort (CCCC) study was designated to measure the trends of cardiovascular morbidity and mortality in a community. Individuals who were aged 35 and above were enrolled. Participants were classified by quartiles of homocysteine concentration. We used multivariate Cox proportional hazards models to calculate the hazard ratio of the fourth quartiles versus the first quartile. Receiver operating characteristic (ROC) curve was constructed, and area under curve was calculated. We also performed stratification to find the effect modifier.
Results：A total of 3602 participants were enrolled, and 2020 participants completed echocardiography. Among the 2020 participants, 231 individual had diastolic dysfunction. Total 75 participants died during follow-up period. After adjusted with multiple variants, hyperhomocysteinemia was significantly associated with poor prognosis with a hazard ratio of 1.07(1.01-1.14). Participants in the highest quartile had a 1.90 ( 95% CI, 0.88-4.12, p for trend, 0.026) fold risk for all cause death compared with those in the lowest quartiles. The hazard ratio was 1.88(95% CI, 1.07-3.29) using 11.11μmol/L as cutpoint.
Conclusion：Hyperhomocysteinemia was significantly associated with poor prognosis in diastolic dysfunction participants. Homocysteine was a good predictor for all-cause death among old age adults.
Subjects
diastolic dysfunction
homocysteine
mortality
The Chin-Shan Community Cardiovascular Cohort
Type
thesis
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