The association of hyperhomocysteinemia with acute post-operative complications following coronary artery bypass grafting

Abstract

Background: Hyperhomocysteinemia is associated with an increased risk for cardiovascular diseases. The influence of hyperhomocysteinemia on post-operative events, after coronary artery bypass surgery graft, is less studied.

Methods: This cross-sectional study aimed to determine if hyperhomocysteinemia was associated with post-operative complications in patients < 50 years who underwent off-pump coronary artery bypass graft for coronary artery disease. A set of major post-operative complications were considered as primary outcome measures. The independent effect of hyperhomocysteinemia and other risk factors in the incidence of post-operative complications was determined by multivariate analysis.

Results: The mean homocysteine levels among the study participants who had post-operative complications were significantly higher than those without post-operative complications (17.37 mmol/L vs. 12.84 mmol/L). On multivariate analysis, hyperhomocysteinemia, diabetes mellitus, and higher body mass index (> 25) were significant predictors of adverse events during the post-operative period.

Conclusion: Hyperhomocysteinemia was a significant predictor of immediate post-operative adverse events after coronary artery bypass surgery graft. Necessary precautions and management strategies have to be evolved for these high-risk subsets.

Keywords: Hyperhomocysteinemia; coronary artery bypass surgery graft; intensive care unit; low cardiac output; sepsis; sternal reopening.