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[Hyperhomocysteinemia and arterial or venous thrombosis. Retrospective study of 75 cases]
N Jacob1, P Cacoub, P Hausfater
1Laboratoire de Biochimie C, Groupe hospitalier Pitié-Salpêtrière, Paris.
Insights
Hyperhomocysteinemia, a condition of high homocysteine levels, is prevalent in patients with arterial and venous thrombosis. Vitamin B supplementation effectively lowered homocysteine in most patients, suggesting a potential therapeutic benefit.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Metabolic Disorders
Context:
- Hyperhomocysteinemia is a suspected risk factor for both arterial and venous thrombosis.
- Previous research indicates a potential link between elevated homocysteine levels and thrombotic events.
- Understanding this association is crucial for developing effective prevention and treatment strategies.
Purpose:
- To investigate the prevalence of hyperhomocysteinemia in patients diagnosed with thrombosis.
- To analyze the relationship between homocysteine levels and other risk factors such as smoking, hypertension, and cholesterol.
- To evaluate the efficacy of vitamin B supplementation in managing hyperhomocysteinemia in this patient cohort.
Summary:
- This retrospective study analyzed 75 patients with thrombosis, finding hyperhomocysteinemia in 89% of cases.
- Elevated homocysteine levels showed no significant correlation with smoking, hypertension, or high cholesterol.
- Vitamin B supplementation in 13 patients led to a decrease in homocysteine levels in 12 and normalization in 9.
Impact:
- The findings highlight the high frequency of hyperhomocysteinemia in patients with arterial and venous thrombosis.
- This underscores the need for further research into the clinical significance of homocysteine-lowering therapies.
- Potential implications for risk stratification and therapeutic interventions in thrombotic disorders.
Objective:
Previous studies suggest that hyperhomocysteinemia may be a risk factor for arterial and venous thrombosis. We retrospectively analyzed data from 75 patients with thrombosis.
Patients And Methods:
Thirty-four patients had arterial thrombosis, 22 venous thrombosis and 19 venous and arterial thrombosis. Of the 75 patients (49 men and 26 women, mean age 49 +/- 15 years) about two-thirds had recurrent episodes of thrombosis.
Results:
Hyperhomocysteinemia was defined as serum homocysteine level above 14.1 mumol/l (mean + 2.7 SD in healthy subjects) and was found in 67 patients (89%, CI95% = 80-95). Mean total homocysteine concentration was 21.6 +/- 13.6 mumol/l for the 75 patients. About half of the patients were smokers, 35% had hypertension and 25% high serum cholesterol. There was no significant relationship between serum homocysteine level and smoking status, hypertension or serum cholesterol level. Ten patients (13%, CI95% = 7-23) had low serum cobalamin (< 150 pmol/l). Serum folates were < or = 10 nmol in 41% of the patients in the arterial thrombosis group (CI95% = 25-59), in 27% in the venous thrombosis group (CI95% = 11-50), and in 31% in the arterial and venous thrombosis group (CI95% = 13-57). Thirteen patients received vitamin B supplementation. Hyperhomocysteinemia decreased in 12/13 patients (CI95% = 64-100) and returned to normal values in 9/13 patients (69%, CI95% = 38-91).
Conclusion:
Our data show that hyperhomocysteinemia is frequently found in arterial and venous thrombosis. Further studies are needed to determine the clinical impact of homocysteine lowering therapy.