Homocysteine and coronary heart disease: a review of the current evidence.

Abstract

The high frequency of premature atherosclerosis in patients with homocystinuria suggested the hypothesis of an association between hyperhomocysteinemia and coronary heart disease. Experimental studies have shown that severe homocysteinemia has toxic effects on the endothelium and may alter haemostatic balance. Although case controls studies have suggested a significant association between mild hyperhomocyst(e)inemia and coronary heart disease, prospective studies have not completely confirmed these findings. Results from the ongoing randomized trials will help determine whether reduction of homocysteine levels will be associated with a reduction of cardiac events and possibly mortality in patients.