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Hyperhomocysteinemia as a risk factor for coronary atherosclerotic diseases in the elderly
ABC
Artigo Original

Hyperhomocysteinemia as a risk factor for coronary atherosclerotic diseases in the elderly

Claudia Felícia Gravina-Taddei et al. Michel Batlouni Camila Sarteschi Valéria T Baltar … Nívea A.C Salvarini Marcelo C Bertolami José Eduardo M. R Sousa

OBJECTIVE: To investigate whether hyperhomocysteinemia is an independent risk factor for atherosclerotic disease in elderly individuals METHODS: A case-control study with 172 elderly individuals, 88 belonging to control group and 84 to case group, who showed coronary angiography requested for clinical indications. Quantitative coronary angiography was performed in 91% of the patients. Homocysteinemia was assessed in a continuous and categorized way, through univariate and multivariate analysis. RESULTS: When analyzed continuously, in univariate analysis, it was verified that case group elderly individuals showed an average homocysteinemia levels significantly higher than the control group individuals’ (14.33±4.59 µmol/l against 11.99±4.59 µmol/l, p=0.015). In multivariate analysis, continuous homocysteinemia was associated to the risk rate for coronary artery disease of 1.07 for each 1 µmol/l increase of homocysteine level. Na increase of 5 µmol/l corresponded to the risk rate of 1.40. When analyzed in categorized way, the values found over percentile 75 of control group (14 µmol/l) were defined as hyperhomocysteinemia. Hyperhomocysteinemia was found in 34% of elderly individuals, being 37.3% in control group and 62.7% in case group (p= 0.009). In multivariate analysis, hyperhomocysteinemia constituted an independent risk factor for coronary atherosclerotic disease for elderly individuals, with a risk rate for coronary artery disease of 2.03, confidence interval 95%, 1.02-4.03. CONCLUSION: Hyperhomocysteinemia was an independent risk factor for coronary artery disease in elderly individuals.

  • Coronary Artery Disease
  • Elderly
  • homocysteine
  • hyperhomocysteinemia
  • octogenarian
  • Risk Factor
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Creative Commons Attribution (CC BY) Creative Commons license
10/10/2005 DOI: 10.1590/S0066-782X2005001600004
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Artigo Original

Safety and feasibility of dobutamine-atropine stress echocardiography in octogenarian patients

José Sebastião de Abreu et al. Tereza Cristina Pinheiro Diógenes Ana Gardenia Liberato Ponte Farias José Maria Bonfim de Morais José Nogueira Paes Júnior

OBJECTIVE: To assess the feasibility and safety of dobutamine-atropine stress echocardiography (DASE) in octogenarians. METHODS: We evaluated 5,467 DASE which were distributed in two groups: group I (GI) with 203 DASE performed in octogenarians, and group II (GII), the control group, with 5,264 DASE. The mean age of GI and GII was 83±3 (80-95) and 59±11 (17-79) years, respectively. DASE parameters that were prospectively collected, were compared and analyzed. RESULTS: The percentage of patients that achieved maximum heart rate was 63.5% in GI and 41% in GII (p<0.001), and GI patients required less atropine compared to GII (GI=47%, GII=78%, p<0.001).The presence of chest pain (GI=13%, GII=15.6%, p=0.429) and DASE positive for myocardial ischemia (GI=20.7%, GII=16.9%, p=0.296) were not statistically different between the two groups. However, concomitant positive DASE and absence of chest pain (GI=17%, GII=11%, p=0.029) was higher in GI. The incidence of premature beats in GI was higher than in GII (GI=47.8%, GII=27.6%, p<0.001), and there were more supraventricular tachyarrhythmias (ST) in GI than in GII (GI=5.9%, GII=1.9%, p=0.001). Out of 11 ST that happened in GI, 9 reverted spontaneously. There weren't either deaths or acute myocardial infarction. Ventricular fibrillation only happened in GII (2 cases, 0.03%). CONCLUSION: In the present study, octogenarians achieved maximum heart rate more frequently despite the lesser amount of atropine that they required for DASE completion. Moreover, in this elderly population, there was a higher correlation between positive DASE and absence of chest pain. Although octogenarians did present more heart rhythm disturbs, they usually resolved spontaneously. In our study, DASE proved to be feasible and safe in octogenarians.

  • Dobutamine
  • Echocardiography
  • octogenarian
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Creative Commons Attribution (CC BY) Creative Commons license
10/10/2005 DOI: 10.1590/S0066-782X2005001600009

How to cite this article

EndNote RIS

Electronic Document Format (Vancouver)

Gravina-Taddei CF, Batlouni M, Sarteschi C, Baltar VT, Salvarini NA, Bertolami MC, Sousa JEMR, et al. Hyperhomocysteinemia as a risk factor for coronary atherosclerotic diseases in the elderly. Arquivos Brasileiros de Cardiologia 2005;85(3):166-73.

Electronic Document Format (ABNT)

Gravina-Taddei, Claudia Felícia; Batlouni, Michel; Sarteschi, Camila; Baltar, Valéria T; Salvarini, Nívea A.C; Bertolami, Marcelo C; Sousa, José Eduardo M. R. Hyperhomocysteinemia as a risk factor for coronary atherosclerotic diseases in the elderly. Arquivos Brasileiros de Cardiologia, v. 85, n. 3, p. 166-173, Oct. 2005.

Electronic Document Format (APA)

Gravina-Taddei, C. F., Batlouni, M., Sarteschi, C., Baltar, V. T., Salvarini, N. A., Bertolami, M. C., & Sousa, J. E. M. R. (2005). Hyperhomocysteinemia as a risk factor for coronary atherosclerotic diseases in the elderly. Arquivos Brasileiros de Cardiologia, 85(3), 166-173.

Electronic Document Format (ISO)

Gravina-Taddei, Claudia Felícia and Batlouni, Michel and Sarteschi, Camila and Baltar, Valéria T and Salvarini, Nívea A.C and Bertolami, Marcelo C and Sousa, José Eduardo M. R. Hyperhomocysteinemia as a risk factor for coronary atherosclerotic diseases in the elderly. Arquivos Brasileiros de Cardiologia [online]. 2005, vol. 85, n. 3, [cited 2026-10-14], pp. 166-173. Available from: <https://journals.cardiol.br/en/article/hyperhomocysteinemia-as-a-risk-factor-for-coronary-atherosclerotic-diseases-in-the-elderly/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Abreu JS, Diógenes TCP, Farias AGLP, Morais JMB, Paes Júnior JN. Safety and feasibility of dobutamine-atropine stress echocardiography in octogenarian patients. Arquivos Brasileiros de Cardiologia 2005;85(3):198-204.

Electronic Document Format (ABNT)

Abreu, José Sebastião de; Diógenes, Tereza Cristina Pinheiro; Farias, Ana Gardenia Liberato Ponte; Morais, José Maria Bonfim de; Paes Júnior, José Nogueira. Safety and feasibility of dobutamine-atropine stress echocardiography in octogenarian patients. Arquivos Brasileiros de Cardiologia, v. 85, n. 3, p. 198-204, Oct. 2005.

Electronic Document Format (APA)

Abreu, J. S. , Diógenes, T. C. P., Farias, A. G. L. P., Morais, J. M. B. , & Paes Júnior, J. N. (2005). Safety and feasibility of dobutamine-atropine stress echocardiography in octogenarian patients. Arquivos Brasileiros de Cardiologia, 85(3), 198-204.

Electronic Document Format (ISO)

Abreu, José Sebastião de and Diógenes, Tereza Cristina Pinheiro and Farias, Ana Gardenia Liberato Ponte and Morais, José Maria Bonfim de and Paes Júnior, José Nogueira. Safety and feasibility of dobutamine-atropine stress echocardiography in octogenarian patients. Arquivos Brasileiros de Cardiologia [online]. 2005, vol. 85, n. 3, [cited 2026-10-14], pp. 198-204. Available from: <https://journals.cardiol.br/en/article/safety-and-feasibility-of-dobutamine-atropine-stress-echocardiography-in-octogenarian-patients/>. ISSN 0066-782X

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