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0015 Background: Elevated total homocysteine levels (tHCY) have  been implicated as an independent risk factor for mortality in patients  with known and no known CAD. Few data are available that compare tHCY  as a predictor of mortality in both groups. Objectives: In an ongoing,  high-risk cardiovascular Prevention Clinic we sought to determine  whether tHCY showed evidence of short-term mortality independently of  traditional risk factors in primary and secondary prevention patients.  Methods: Short term mortality (mean follow-up 26 ± 15 months) was  assessed in 2441 clinic patients (1103 primary and 1338 secondary  prevention). Cox models were used to assess the unadjusted  relationships between tHCY (quartiles:  14.7 μmol/L) and survival time with hazard ratios (HR) used to  estimate mortality risk. Framingham global risk scores were calculated  for each patient in order to adjust for traditional risk factors (age,  gender, LDL-C, HDL-C, blood pressure, diabetes and smoking). Results:  The mean age of the overall group was 56 ± 12 years, 34% were  women and 62 patients died during the follow-up (18 for primary and 44  for secondary prevention). Serum tHCY quartile showed a relationship to  mortality for primary and secondary prevention patients (HR 3.02 and  1.69 respectively) with and without adjustment for traditional risk  factors and creatinine (Table). Conclusions: Serum homocysteine levels  are independently associated with mortality in primary and secondary  Prevention patients derived from the same high-risk clinic  population.Table 1.

circulation

Serum Homocysteine levels are independently associated with mortality in Primary and Secondary Prevention patients derived from a high-risk clinic population.