Homocysteine, folate and vitamin b12 in patients with coronary heart disease.

Background/aims: Homocysteine and possibly also folate and vitamin B(12) are involved in the pathogenesis of cardiovascular disease. We investigated the prevalence of hyperhomocysteinemia in patients with coronary heart disease (CHD), as well as folate and vitamin B(12), the main nutritional factors determining the level of homocysteine.

Methods: Patients with angiographically documented CHD were prospectively investigated (n = 315, 70% male, mean age 61 [range 36-81] years).

Implementation of guidelines improves the standard of care: the Viennese registry on reperfusion strategies in ST-elevation myocardial infarction (Vienna STEMI registry).

Background: The purpose of this study was to determine whether implementation of recent guidelines improves in-hospital mortality from acute ST-elevation myocardial infarction (STEMI) in a metropolitan area.

Methods And Results: We organized a network that consisted of the Viennese Ambulance Systems, which is responsible for diagnosis and triage of patients with acute STEMI, and 5 high-volume interventional cardiology departments to expand the performance of primary percutaneous catheter intervention (PPCI) and to use the fastest available reperfusion strategy in STEMI of short duration (2 to 3 hours from onset of symptoms), either PPCI or thrombolytic therapy (TT; prehospital or in-hospital), respectively. Implementation of guidelines resulted in increased numbers of patients receiving 1 of the 2 reperfusion strategies (from 66% to 86.

Cardiovascular magnetic resonance: current clinical practice and future potential.

Cardiovascular magnetic resonance (CMR) is playing an increasing role in the noninvasive assessment of the cardiothoracic patient. It provides rapid, high-resolution anatomical coverage, and accurate functional cardiovascular assessment without the need for ionizing radiation. In this article, we discuss the fundamental principles of CMR and outline the established and newer indications for its use.

Relation of homocysteine, vitamin B(12), and folate to coronary in-stent restenosis.

Coronary in-stent restenosis represents a clinical problem. Because homocysteine is being discussed as a new risk factor for atherosclerosis and thrombosis, this study investigated the relations of homocysteine, folate, and vitamin B(12) to the rate of in-stent restenosis. Patients undergoing successful percutaneous transluminal coronary angioplasty of native coronary lesions with stent implantation were investigated for fasting total serum homocysteine, folic acid, and vitamin B(12).