Plasma homocysteine and restenosis after femoropopliteal angioplasty

Purpose: To assess the relationship between plasma homocysteine levels and restenosis after femoropopliteal percutaneous transluminal angioplasty.Methods: Over a 10-month period, 128 consecutive, symptomatic patients (72 men; median age 70 years) having successful femoropopliteal angioplasty for atherosclerotic occlusive disease were prospectively enrolled in the study. Plasma homocysteine levels were determined the day before the procedure. The primary endpoint was restenosis >50%, documented by duplex sonography, at up to 12 months' follow-up. Cox proportional hazards analysis was used to determine the risk of restenosis in relation to pretreatment homocysteine levels.Results: The restenosis rate at 12 months was 46%. Median baseline plasma homocysteine levels were not different in patients with and without restenosis (15.4 versus 16.7 micromol/L, p=0.30). Compared to patients with homocysteine levels /=19.7 micromol/L (upper tertile, n=42) (p=0.38). Multivariate analysis showed that lesion length (p