Homocysteine enzymatic

Homocysteine is a strong, independent risk factor for cardiovascular disease

Numerous clinical and epidemiologic studies have established elevated blood homocysteine (HCY) as a potent independent risk factor for vascular disease²:

• Subsequent observations from approximately 80 clinical and epidemiologic studies have demonstrated that hyperhomocysteinemia is an independent, dose-dependent risk factor for atherosclerotic vascular disease and for arterial and venous thromboembolism³
• For example, moderate to intermediate hyperhomocysteinaemia  is present in 12 - 47% of patients with coronary, cerebral, or peripheral arterial occlusive diseases²

Homocysteine is an early risk marker for high-risk patients

• Meta-analysis of 72 studies has demonstrated significant associations between homocysteine and the risk of ischaemic heart disease, deep vein thrombosis, pulmonary embolism and stroke. The results of the meta-analysis provide further strong evidence for a causal relationship between elevated homocysteine and CVD⁴
• Modest reduction of homocysteine is predicted to lower the risk of CVD up to 25%⁴

Fig. Predicted decrease in CVD risk following reduction in blood total homocysteine concentration.⁴ Whiskers represent the upper and lower 95% confidence intervals for the calculated decrease in risk.

Homocysteine provides additional prognostic information over cholesterol

Numerous studies have shown the connection between HCY levels and atherosclerosis. A concentration-dependent correlation between HCY and cardiovascular risk has been established from the Framingham study.⁵ A 5 μmol/L increase in HCY is equivalent to approx.
1.1 mmol/L increase in total cholesterol level.⁶

Homocysteine as a risk factor for coronary heart disease

Boushey, et al., performed a meta-analysis of 27 clinical studies, and summarised the odds ratio between elevated HCY and development of vascular disease. The authors found an OR of 1.6 (95 % CI, 1.4 to 1.7) for men and 1.8 (95 % CI, 1.3 to 1.9) for women for a 5-μmol/L HCY increment, suggesting that about 10 % of the population’s CHD risk appears attributable to HCY.⁶ This stimulated clinical investigations of HCY as a risk factor for coronary heart disease (CHD) and its use in clinical patient care.