Cingozbay B Y, Yiginer O, Cebeci B S, Kardesoglu E, Demiralp E, Dincturk M
GATA Military Medical Training Hospital, Cardiology Department, Haydarpasa, Istanbul, Turkey.
Blood Coagul Fibrinolysis. 2002 Oct;13(7):609-13. doi: 10.1097/00001721-200210000-00005.
Thromboembolism is the most important complication in patients with atrial fibrilation (AF). Homocysteine is a toxic amino acid that has been recently accepted as a risk factor for atherosclerosis and stroke. The aim of the present study is to show whether there is a relation between hyperhomocysteinemia and thromboembolic complications in patients with non-valvular AF. We admitted 38 patients with non-valvular AF. The patients were divided into two groups: group A (n = 20; mean age, 75.7 +/- 10.4 years; three males/17 females), and group B (n = 18; mean age, 68.0 +/- 10.6 years; 11 males/seven females). While group A consisted of the patients with AF and stroke, group B was composed of the patients with AF but without stroke. The patients having sinus rhythm (15 subjects) were used as the reference group to obtain the cut-off value. Homocysteine was measured by the immunoassay method. The means of the homocysteine levels were 12.4 +/- 3.3 micromol/l in group A, 8.3 +/- 2.3 micromol/l in group B and 9.3 +/- 1.8 micromol/l in the reference group. The cut-off value was 10.6 micromol/l. Group A had a statistically higher homocysteine level than not only group B, but also the reference group (P < 0.05). While 60% of group A (n = 12) had the elevated homocysteine level, the rate was only 22% for group B (n = 4). In conclusion, hyperhomocysteinemia may be one of the explanations for the increased rate of thromboembolic complications in older patients with AF.
血栓栓塞是心房颤动（AF）患者最重要的并发症。同型半胱氨酸是一种有毒氨基酸，最近已被公认为动脉粥样硬化和中风的危险因素。本研究的目的是表明非瓣膜性AF患者的高同型半胱氨酸血症与血栓栓塞并发症之间是否存在关联。我们收治了38例非瓣膜性AF患者。患者分为两组：A组（n = 20；平均年龄75.7±10.4岁；3名男性/17名女性）和B组（n = 18；平均年龄68.0±10.6岁；男性11名/女性7名）。A组由AF合并中风的患者组成，B组由AF但无中风的患者组成。将有窦性心律的患者（15名受试者）用作参考组以获得临界值。采用免疫测定法测定同型半胱氨酸。A组同型半胱氨酸水平的平均值为12.4±3.3微摩尔/升，B组为8.3±2.3微摩尔/升，参考组为9.3±1.8微摩尔/升。临界值为10.6微摩尔/升。A组的同型半胱氨酸水平在统计学上不仅高于B组，也高于参考组（P < 0.05）。A组60%（n = 12）的患者同型半胱氨酸水平升高，而B组这一比例仅为22%（n = 4）。总之，高同型半胱氨酸血症可能是老年AF患者血栓栓塞并发症发生率增加的原因之一。
