A prospective study on hyperhomocysteinemia as an aggravating factor in chronic venous insufficiency

The role of hyperhomocysteinemia (HH) in the etiopathogenetics of systemic thrombotic events has been confirmed by numerous studies. However, it has been insufficiently studied as an etiopathogenic factor in chronic venous insufficiency (CVI). The present prospective study included 166 patients with CVI at stages C3-C6. Homocysteine levels and the inflammatory, metabolic and procoagulant profiles of the patients were determined. High-performance liquid chromatography was used to determine the homocysteine level. Within the patients with HH, the thromboembolic risk was analyzed. Smoking was determined to represent the most common procoagulant factor (21.67%), whereas in the subgroup of women, abortions represented a procoagulant factor for 31.93%. The metabolic profile was altered in approximately half of all cases (42.77%), whereas proinflammatory status was a contributing factor in 23.50% of the cases. HH was present in 54.22% of the CVI patients, mainly in the moderate HH category (53.01%), mostly linked to venous ulcers, thrombophlebitis and pulmonary thromboembolisms. The highest average values of homocysteine were recorded in patients >75 years old and when the venous disease age was >20 years (15.03 µmol/l). In summary, in the present study, HH was a contributing factor of CVI alongside the chronic inflammation that is well known in CVI, which increased thrombogenic risk, especially in elderly patients with an advanced age of venous disease.