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Homocysteine, endothelial dysfunction, and coronary artery disease: emerging strategy for secondary prevention

Kam Sang Woo1, Mu Qiao, Ping Chook

  • 1Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China. kamsangwoo@cuhk.edu.hk

Journal of Cardiac Surgery
|March 13, 2003
PubMed

Insights

Elevated homocysteine levels are an independent risk factor for atherosclerosis, impacting endothelial function. Ongoing trials are investigating homocysteine-lowering therapies for stroke and heart attack prevention.

Area of Science:

  • Cardiovascular Science
  • Metabolic Disorders
  • Vascular Biology

Background:

  • Atherosclerosis remains a significant health challenge, with traditional risk factors explaining only half of its prevalence.
  • Hyperhomocysteinemia is increasingly recognized as an independent risk factor for atherosclerosis.
  • Factors like folate deficiency, renal failure, and MTHFR gene variations contribute to hyperhomocysteinemia.

Purpose of the Study:

  • To review the emerging evidence linking hyperhomocysteinemia to atherosclerosis.
  • To highlight the prevalence of hyperhomocysteinemia in various populations.
  • To discuss the potential of homocysteine-lowering interventions for cardiovascular disease prevention.

Main Methods:

  • Review of existing case-control and prospective cohort studies.
  • Inclusion of in vitro and in vivo experimental models.
  • Analysis of data from human subjects and clinical trials.

Main Results:

  • Hyperhomocysteinemia is prevalent in diverse populations, particularly in those with premature coronary artery disease.
  • Strong associations between elevated homocysteine and atherosclerosis are documented across multiple study types.
  • Homocysteine-lowering interventions have shown promise in improving endothelial function.

Conclusions:

  • Hyperhomocysteinemia is a significant, independent risk factor for atherosclerosis.
  • Further large-scale trials are crucial to establish homocysteine-lowering therapies for primary and secondary cardiovascular prevention.
  • These trials will provide evidence for preventing stroke and heart attacks.

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