Trends in clinical laboratory homocysteine testing from 1997 to 2010: the impact of evidence on clinical practice at a single institution

Corinne M Klykov; Steven R Lentz

doi:10.1515/cclm-2012-0637

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Trends in clinical laboratory homocysteine testing from 1997 to 2010: the impact of evidence on clinical practice at a single institution

Journal article

Open access

Peer reviewed

Trends in clinical laboratory homocysteine testing from 1997 to 2010: the impact of evidence on clinical practice at a single institution

Corinne M Klykov and Steven R Lentz

Clinical chemistry and laboratory medicine, Vol.51(3), pp.671-675

03/01/2013

DOI: 10.1515/cclm-2012-0637

PMCID: PMC3706201

PMID: 23152416

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Abstract

During the past decade, several clinical trials investigating the potential benefits of homocysteine-lowering therapy for the secondary prevention of vascular events were completed and published. The objective of the study was to determine trends in clinical laboratory testing for homocysteine at a single institution over the time period from 1997 to 2010. A single-center, retrospective analysis was performed at a large, academic, tertiary care medical center in the USA. The database was searched for clinical laboratory measurements of plasma or serum homocysteine between January 1, 1997 and December 31, 2010. Individual medical records were reviewed for a subset of 221 unique patients in the 10-year period from 2001 to 2010 who had homocysteine values ≥20 μmol/L. From 1997 to 2003, there was a 16-fold increase in the annual number of homocysteine assays performed. Testing for homocysteine declined in 2004 and 2006, coinciding with the publication of intervention trials that failed to support a clinical benefit of homocysteine-lowering therapy for the secondary prevention of vascular events. Subgroup analysis suggested that homocysteine testing for the indication of suspected nutritional deficiency or hypercoagulability remained steady despite a decline in testing for the indication of cardiac risk assessment. The frequency of clinical laboratory testing for plasma or serum homocysteine changed bimodally over the time period from 1997 to 2010. These observations suggest that clinical practice was impacted by emerging evidence from association studies and intervention trials investigating homocysteine as a potentially treatable cardiac risk factor.

Heart Diseases - diagnosis

Laboratories, Hospital

Risk Assessment

Humans

Homocysteine - blood

Retrospective Studies

Blood Chemical Analysis - trends

Heart Diseases - pathology

Databases, Factual

Details

Title: Subtitle: Trends in clinical laboratory homocysteine testing from 1997 to 2010: the impact of evidence on clinical practice at a single institution
Creators: Corinne M Klykov - Department of Internal Medicine, The University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
Steven R Lentz
Resource Type: Journal article
Publication Details: Clinical chemistry and laboratory medicine, Vol.51(3), pp.671-675
DOI: 10.1515/cclm-2012-0637
PMID: 23152416
PMCID: PMC3706201
NLM abbreviation: Clin Chem Lab Med
ISSN: 1434-6621
eISSN: 1437-4331
Grant note: R01 HL063943 / NHLBI NIH HHS P01 NS024621 / NINDS NIH HHS
Language: English
Date published: 03/01/2013
Academic Unit: Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
Record Identifier: 9984094355902771

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