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Homocysteine level and coronary heart disease incidence: a systematic review and meta-analysis

Linda L Humphrey1, Rongwei Fu, Kevin Rogers

  • 1Department of Medical Informatics and Clinical Epidemiology, Public Health and Preventive Medicine, Oregon Health and Science University, Portland, OR 97239-3098, USA.

Mayo Clinic Proceedings
|November 8, 2008
PubMed

Insights

Elevated homocysteine levels significantly increase the risk of coronary heart disease (CHD). A 5 micromol/L rise in homocysteine independently boosts CHD event risk by about 20%.

Area of Science:

  • Cardiovascular epidemiology
  • Clinical biochemistry

Background:

  • Coronary heart disease (CHD) remains a leading cause of mortality worldwide.
  • Identifying novel risk factors is crucial for effective prevention strategies.
  • Homocysteine has been investigated as a potential contributor to CHD development.

Purpose of the Study:

  • To evaluate if elevated homocysteine levels are an independent risk factor for incident coronary heart disease (CHD).
  • To provide evidence for the US Preventive Services Task Force's assessment of novel CHD risk factors.

Main Methods:

  • A systematic review and meta-analysis of prospective cohort studies were conducted.
  • Studies published between 1966 and March 2006 were identified via MEDLINE and reference lists.
  • Quality-rated studies measuring homocysteine and CHD incidence in adults without prior CHD were included.

Main Results:

  • Twenty-six high-quality articles were analyzed.
  • A 5 micromol/L increase in homocysteine was associated with a 20% to 50% elevation in CHD risk across most studies.
  • The meta-analysis revealed a combined risk ratio of 1.18 (95% CI, 1.10-1.26) for coronary events per 5 micromol/L homocysteine increase.

Conclusions:

  • Elevated homocysteine levels independently increase the risk of coronary heart disease events.
  • Each 5 micromol/L increment in homocysteine raises CHD risk by approximately 20%.
Abstract

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