Abstract
Previous studies have reported inconsistent results regarding the association between homocysteine (Hcy) levels and calcific aortic valve disease (CAVD). We investigate the association between Hcy levels in patients with CAVD and controls by conducting a systematic review and meta-analysis. We conducted a systematic search of studies published prior to the end of March 2017 in the PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials and the Chinese Biomedical Literature databases. Eligible studies evaluating plasma Hcy levels in CAVD patients and controls were identified by two independent investigators. Standardized mean difference (SMD) and the corresponding 95% confidence intervals (95% CIs) were estimated using the random-effects model. Ten studies involving 6349 participants were included. Pooled analysis demonstrated that Hcy levels were significantly elevated in patients with CAVD compared with controls (pooled SMD: 0.57, 95% CI: 0.36–0.79). This elevation was more obvious in American and Asian populations than in Turkish populations. Furthermore, Hcy levels were significantly elevated in patients with mild-to-moderate CAVD and severe CAVD. Our results demonstrate that CAVD is associated with elevated Hcy levels.
Highlights
Calcific aortic valve disease (CAVD) is the most common valvular disorder among the aging population— roughly one-third of all individuals over an age of 65 have mild calcific aortic valve disease (CAVD), manifested as aortic valve sclerosis (AVSc) [1]
Pooled analysis demonstrated that Hcy levels were significantly elevated in patients with CAVD compared with controls
A deep understanding of the risk factors of CAVD provides the foundation for preventive methods and medical therapies for this disease
Summary
Calcific aortic valve disease (CAVD) is the most common valvular disorder among the aging population— roughly one-third of all individuals over an age of 65 have mild CAVD, manifested as aortic valve sclerosis (AVSc) [1]. With the progression of the pathological condition, aortic valve stenosis (AVS) may appear, in which left ventricular outflow obstruction is presented. This end-stage of CAVD leads to lifethreatening diseases such as heart failure. Surgical aortic valve replacement or transcatheter aortic valve replacement is required to avoid the risk of death. It becomes urgent to understand modifiable risk factors of CAVD to guide prevention and treatment strategies
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