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Hyperhomocysteinemia and venous thrombosis: a meta-analysis
M den Heijer1, F R Rosendaal, H J Blom
1Department of Hematology, Leyenburg Hospital, The Hague, The Netherlands. m.denheijer@AIG.AZN.NL
Thrombosis and Haemostasis
|December 30, 1998
Summary
Elevated homocysteine levels (hyperhomocysteinemia) are a significant risk factor for venous thrombosis. This meta-analysis confirms hyperhomocysteinemia increases the risk of blood clots in veins.
Area of Science:
- Cardiovascular Medicine
- Thrombosis Research
- Metabolic Disorders
Background:
- Hyperhomocysteinemia is a known risk factor for atherosclerosis and vascular disease.
- The association between hyperhomocysteinemia and venous thrombosis was previously debated.
- Ten case-control studies have investigated this relationship.
Purpose of the Study:
- To conduct a meta-analysis of existing case-control studies.
- To determine if hyperhomocysteinemia is a risk factor for venous thrombosis.
Main Methods:
- MEDLINE search from 1984 to June 1997 using keywords 'homocysteine' or 'hyperhomocysteinemia' and 'venous thrombosis'.
- Inclusion of ten eligible case-control studies.
- Pooled analysis of odds ratios for elevated homocysteine concentrations.
Main Results:
- A pooled odds ratio of 2.5 (95% CI 1.8-3.5) was found for fasting plasma homocysteine above the 95th percentile.
- A pooled odds ratio of 2.6 (95% CI 1.6-4.4) was found for post-methionine increase in homocysteine concentration.
- These findings support hyperhomocysteinemia as a risk factor for venous thrombosis.
Conclusions:
- Hyperhomocysteinemia is a confirmed risk factor for venous thrombosis.
- Further research is needed on the underlying mechanisms and the impact of vitamin supplementation on homocysteine levels and clinical outcomes.