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The Influence of Total Plasma Homocysteine and Traditional Atherosclerotic Risk Factors on Degree of Abdominal Aortic Aneurysm Tissue Inflammation

Vascular Surgical Unit, 2nd Surgical Department, Aretaieion Hospital, Medical School, University of Athens, Greece, arapoglu{at}aretaieio.uoa.gr

Agathi Kondi-Pafiti, MD, PhD

Pathology Laboratory, Aretaieion Hospital, Medical School, University of Athens, Greece

Demetrios Rizos, PhD

Hormone Laboratory, Aretaieion Hospital, Medical School, University of Athens, Greece

Thomas Kotsis, MD, PhD

Vascular Surgical Unit, 2nd Surgical Department, Aretaieion Hospital, Medical School, University of Athens, Greece

Christos Kalkandis, MD

Vascular Surgical Unit, 2nd Surgical Department, Aretaieion Hospital, Medical School, University of Athens, Greece

Konstantinos Katsenis, MD, PhD

Vascular Surgical Unit, 2nd Surgical Department, Aretaieion Hospital, Medical School, University of Athens, Greece

Objective: Modulating effects of genetic and environmental risk factors on severity of human abdominal aortic aneurysm (AAA) tissue inflammation remain unclear. We investigated the influence of total plasma homocysteine (tHcy) and traditional atherosclerotic risk factors (ARF) on degree of AAA tissue inflammation. Methods: Aneurysm specimens were obtained from 89 male patients aged 52 to 83 years, underwent asymptomatic not ruptured AAA (mean diameter 5.5 cm) open repair and graded for degree of histologic inflammation. Multivariate analysis was used to determine the association of tHcy and ARF, with degree of inflammation. Results: Current cigarette smoking, odds ratio (OR) 4.4, 95% confidence interval 1.3 to 15.2, P = .01 and no other ARF, neither tHcy levels OR 0.9 (0.9-1.02), P = .2 were associated with high-grade tissue inflammation. Conclusion: These results provide evidence against a major effect of tHcy levels on AAA tissue inflammation, while current cigarette smoking is a significant modulating factor.

Key Words: abdominal aortic aneurysm • inflammation • atherosclerotic risk factors • homocysteine

This version was published on October 1, 2009

Vascular and Endovascular Surgery, Vol. 43, No. 5, 473-479 (2009)
DOI: 10.1177/1538574409334345


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