Hyperhomocysteinemia in patients with pulmonary embolism

Abstract

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.