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Homocysteine in cardiovascular disease: a culprit or an innocent bystander?

Mudgal Anantrao Kothekar1

  • 1Clinical Development, Nicholas Piramal Research Centre, Goregaon (E), Mumbai, India. kothekarashish@rediffmail.com

Indian Journal of Medical Sciences
|June 15, 2007
PubMed

Insights

Hyperhomocysteinemia is an independent risk factor for cardiovascular disease (CVD), challenging the view of it being merely an epiphenomenon. However, the necessity of homocysteine-lowering therapy for CVD prevention remains debated.

Area of Science:

  • Cardiovascular Medicine
  • Clinical Biochemistry

Background:

  • The role of hyperhomocysteinemia as a cardiovascular disease (CVD) risk factor is debated.
  • Numerous studies exist, yet a consensus on its etiological significance and the need for treatment is lacking.

Purpose of the Study:

  • To review and present evidence supporting and refuting the association between hyperhomocysteinemia and CVD.
  • To inform medical practitioners about the current scientific discourse on hyperhomocysteinemia and CVD.

Main Methods:

  • Comprehensive review of prospective and retrospective studies.
  • Analysis of clinical, epidemiologic, genetic studies, reviews, and meta-analyses.
  • Examination of arguments for and against hyperhomocysteinemia as an independent CVD risk factor.

Main Results:

  • Available evidence suggests homocysteine is an independent risk factor for CVD.
  • Hyperhomocysteinemia is not considered an innocent bystander in CVD pathogenesis.

Conclusions:

  • Homocysteine is identified as an independent risk factor for cardiovascular disease.
  • The clinical utility and necessity of homocysteine-lowering therapy for CVD prevention are not yet definitively established.
  • Physicians must stay informed on this evolving topic.

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