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Homocysteine and coronary artery disease
K Robinson1, E Mayer, D W Jacobsen
1Department of Cardiology, Cleveland Clinic Foundation, OH 44195.
Cleveland Clinic Journal of Medicine
|November 1, 1994
Summary
Homocystinuria, a disease causing high homocysteine levels, is linked to premature atherosclerosis and blood clots. Vitamin supplementation may help lower homocysteine, but its routine use for heart disease prevention needs more study.
Area of Science:
- Biochemistry
- Genetics
- Cardiovascular Medicine
Background:
- Homocystinuria is a rare genetic disorder characterized by elevated homocysteine levels.
- This condition is associated with early-onset and severe occlusive arterial disease.
- Milder hyperhomocysteinemia is increasingly recognized as an independent risk factor for coronary artery disease.
Purpose of the Study:
- To review the link between high homocysteine concentrations and arterial disease.
- To explore the metabolic pathways of homocysteine and causes of hyperhomocysteinemia.
- To discuss the potential adverse effects of homocysteine on vascular health.
Main Methods:
- Literature review of studies on homocystinuria, hyperhomocysteinemia, and cardiovascular disease.
- Analysis of the role of homocysteine metabolism and associated deficiencies (e.g., vitamins B6, B12, folic acid).
- Examination of evidence linking plasma homocysteine levels to occlusive arterial disease.
Main Results:
- Patients with homozygous homocystinuria frequently develop premature atherosclerosis and thromboembolism.
- Elevated homocysteine levels are significantly higher in individuals with occlusive arterial disease compared to controls.
- Potential contributing factors include vitamin deficiencies and genetic variations like cystathionine synthase deficiency.
Conclusions:
- High homocysteine concentrations likely contribute to atherosclerosis and thromboembolism in homocystinuria.
- Homocysteine may negatively impact platelets, clotting factors, and endothelial cells.
- Further research is needed to determine the routine measurement and therapeutic efficacy of lowering homocysteine in coronary artery disease patients.