Association of elevated plasma homocysteine levels with impaired ST-segment resolution after fibrinolytic therapy in acute ST-elevation myocardial infarction

Objective Elevated plasma homocysteine levels are associated with increased intracoronary thrombus burden in acute coronary syndromes. The relationship between plasma homocysteine levels and ST-segment resolution (STR) after fibrinolytic therapy has, however, not been investigated. We sought to investigate this issue. Methods Forty-nine patients who were administered fibrinolytic therapy for ST-segment elevation myocardial infarction (STEMI) were included in this study. Maximum STR was measured after 90 min of fibrinolytic therapy. Patients with a maximum STR of less than 50% were included in group 1. Patients with a maximum STR >= 50% were included in group 2. Blood samples were collected from the antecubital vein upon arrival to the hospital. The plasma was separated and kept at - 70 degrees C until the time of analysis. Total plasma homocysteine level was determined by the high-performance liquid chromatography method with fluorescence detection. Results Fifteen patients in group 1 and 34 patients in group 2 were present. Baseline characteristics were similar in both groups. The plasma homocysteine levels were 22.5 +/- 10 mu mol/l in group 1 and 14.1 +/- 4 mu mol/l in group 2 (P < 0.001). Conclusion Elevated plasma homocysteine levels are associated with impaired STR after fibrinolytic therapy in acute STEMI.