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Homocysteine and coronary heart disease: a review of the current evidence

V Pasceri1, J T Willerson

  • 1University of Texas Medical School and Memorial Hermann Hospital, Houston, TX, USA. vpasceri@hotmail.com

Seminars in Interventional Cardiology : SIIC
|November 5, 1999
PubMed

Insights

High homocysteine levels (hyperhomocysteinemia) may link to coronary heart disease. Ongoing trials investigate if lowering homocysteine reduces cardiac events and mortality.

Area of Science:

  • Cardiovascular Science
  • Metabolic Disorders

Background:

  • Premature atherosclerosis in homocystinuria patients suggests a link between hyperhomocysteinemia and coronary heart disease.
  • Severe homocysteinemia exhibits endothelial toxicity and may disrupt hemostatic balance.

Purpose of the Study:

  • To investigate the association between hyperhomocysteinemia and coronary heart disease.
  • To evaluate the impact of homocysteine reduction on cardiac events and mortality.

Main Methods:

  • Review of experimental studies on homocysteinemia's effects.
  • Analysis of case-control studies on mild hyperhomocysteinemia and heart disease.
  • Monitoring results from ongoing randomized trials.

Main Results:

  • Experimental data indicate endothelial toxicity and hemostatic alterations with severe homocysteinemia.
  • Case-control studies suggest an association between mild hyperhomocysteinemia and coronary heart disease.
  • Prospective studies have yielded inconsistent findings regarding this association.

Conclusions:

  • The relationship between hyperhomocysteinemia and coronary heart disease requires further clarification.
  • Randomized trials are crucial to determine if homocysteine level reduction impacts cardiac events and mortality.

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