Objective： To investigate whether elevated homocysteine levels were a predictor of subsequent coronary heart disease （CHD） mortality, cardiovascular mortality or all-cause mortality in the general population by a m...Objective： To investigate whether elevated homocysteine levels were a predictor of subsequent coronary heart disease （CHD） mortality, cardiovascular mortality or all-cause mortality in the general population by a meta- analysis. Methods： In a systematic search conducted in the databases of PubMed and Embase prior to October 2013, we identified relevant prospective observational studies evaluating the association between baseline homocysteine levels and CHD mortality, cardiovascular or all-cause mortality in the general population. Pooled adjust risk ratio （RR） and corresponding 95% confidence interval （CI） were calculated separately for categorical risk estimates and con- tinuous risk estimates. Results： Twelve studies with 23 623 subjects were included in the meta-analysis. Comparing the highest to lowest homocysteine level categories, CHD mortality increased by 66% （RR 1.66; 95% CI 1.12-2.47; P=-0.012）, cardiovascular mortality increased by 68% （RR 1.68; 95% CI 1.04-2.70; P=0.033）, and all-cause mortality increased by 93% （RR 1.93; 95% CI 1.54-2.43; P〈0.001）. Moreover, for each 5 pmol/L homocysteine increment, the pooled RR was 1.52 （95% CI 1.26-1.84; ,〈0.001） for CHD mortality, 1.32 （95% CI 1.08-1.61; P=0.006） for cardio- vascular mortality, and 1.27 （95% CI 1.03-1.55; P=-0.023） for all-cause mortality. Conclusions： Elevated homocysteine levels are an independent predictor for subsequent cardiovascular mortality or all-cause mortality, and the risks were more pronounced among elderly persons.展开更多
文摘Objective： To investigate whether elevated homocysteine levels were a predictor of subsequent coronary heart disease （CHD） mortality, cardiovascular mortality or all-cause mortality in the general population by a meta- analysis. Methods： In a systematic search conducted in the databases of PubMed and Embase prior to October 2013, we identified relevant prospective observational studies evaluating the association between baseline homocysteine levels and CHD mortality, cardiovascular or all-cause mortality in the general population. Pooled adjust risk ratio （RR） and corresponding 95% confidence interval （CI） were calculated separately for categorical risk estimates and con- tinuous risk estimates. Results： Twelve studies with 23 623 subjects were included in the meta-analysis. Comparing the highest to lowest homocysteine level categories, CHD mortality increased by 66% （RR 1.66; 95% CI 1.12-2.47; P=-0.012）, cardiovascular mortality increased by 68% （RR 1.68; 95% CI 1.04-2.70; P=0.033）, and all-cause mortality increased by 93% （RR 1.93; 95% CI 1.54-2.43; P〈0.001）. Moreover, for each 5 pmol/L homocysteine increment, the pooled RR was 1.52 （95% CI 1.26-1.84; ,〈0.001） for CHD mortality, 1.32 （95% CI 1.08-1.61; P=0.006） for cardio- vascular mortality, and 1.27 （95% CI 1.03-1.55; P=-0.023） for all-cause mortality. Conclusions： Elevated homocysteine levels are an independent predictor for subsequent cardiovascular mortality or all-cause mortality, and the risks were more pronounced among elderly persons.
