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Published on: October 12, 2017

Is Hyperhomocyst(e)inemia a humoral predictor of coronary heart disease?

A Virdis1, L Ghiadoni, D Versari

  • 1Department of Internal Medicine, University of Pisa, Pisa, Italy. a.virdis@med.unipi.it

Current Pharmaceutical Design
|July 20, 2005
PubMed

Insights

Elevated homocysteine levels may predict coronary heart disease, but its role in cardiovascular events, especially with hypertension, requires more research. Folic acid

Area of Science:

  • Cardiovascular Medicine
  • Biochemistry
  • Public Health

Background:

  • Elevated plasma homocysteine is linked to prothrombotic and proatherosclerotic effects.
  • Homocysteine is a modest independent predictor of coronary heart disease (CHD).
  • The interaction between hyperhomocysteinemia, hypertension, and cardiovascular events is not well-established.

Purpose of the Study:

  • To review the current evidence on the association between homocysteine levels and cardiovascular events.
  • To evaluate the role of hyperhomocysteinemia in high-risk patients and secondary prevention.
  • To discuss the implications for folic acid therapy in patients with CHD.

Main Methods:

  • Review of prospective studies and longitudinal data.
  • Analysis of findings from clinical trials on homocysteine-lowering therapy.
  • Synthesis of evidence regarding the impact of homocysteine on cardiovascular risk.

Main Results:

  • Homocysteine is a modest predictor of CHD.
  • Longitudinal studies suggest an association with recurrent cardiovascular events in high-risk patients.
  • Prospective studies have not consistently shown a protective effect of homocysteine-lowering therapy in secondary prevention.

Conclusions:

  • The definitive impact of mild hyperhomocysteinemia on CHD requires further establishment.
  • Widespread homocysteine level determination is not recommended for the general population.
  • Homocysteine knowledge is crucial for high-risk patients and those with unexplained cardiovascular events.

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