Comparison of Long-tip Electrode Catheter and Standard Catheter for Radiofrequency Ablation of Typical Atrial Flutter

Although the effects of elevation of homocysteine and lipoprotein (a) in plasma have widely been Türk Kardiyol Dem Arş 2001; 29: 396-399 investigated recently as a risk factor in coronary artery disease, the resuts of the studies and meta analyses are stili controversial. To that end, we investigated the significance of homocystein and Iipoprotein (a) levels as risk factors as well on their interaction, in a group of 92 patients with to acute myocardial infaretion and a group of 30 controls, all among 45 years-old. Although plasma homocystein levels were significantly higher in patients who sustained a to myocardial infaretion compared to the control group [geometric mean 12.4 ı.ımol/L (%95 CI 10.9-13.9 ı.ımol/L) and 10.0 (mol/L (%95 CI 5. 1-14.9 ı.ımol/L)], Lp(a) levels were similar in both groups. When homocystein and lipoprotein levels were divided in to quartiles, MI risk was significantly increased (OR 1.54) in the fourth quartile of homocystein. There was no significant difference between quartiles of Iipoprotein (a). When all subjects were separated according to the 90'" percentile of homocystein and lipoprotein (a) of the control group, patients with values above this percentile fo r homocystein had a significantly independent risk for MI in both univariate and multivariate analysis (p=O.Ol, OR 1.87 %95 CI 1.34- 2.75). Moreover lipoprotein (a) had no potential effect on the risk potential of homocystein. The strongest independent risk factors in subjects under 45 years-old were smoking (p=0,0004) and total cholesteroi/HDL-C ratio (p=O.O 1 ). Homocystein levels were higher in smokers compared to nonsmokers (p=0.004). lt was, there fore concluded that an increased level of plasma homocystein was a significant independent risk factor for myocardial infaretion in those under 45 years-old, where as elevated lipoprotein(a) level was not.