Question: What is the role of homocysteine in thrombosis?
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Unique Identifier 98181803
Authors: Welch GN. Loscalzo J.
Institution: Whitaker Cardiovascular Institute and Evans Department of Medicine, Boston University School of Medicine, MA 02118, USA.
Title: Homocysteine and atherothrombosis. [Review] [102 refs]
Source: New England Journal of Medicine. 338(15)1042-50, 1998 Apr 9.
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Unique Identifier 97134786
Authors: Guba SC. Fink LM. Fonseca V.
Institution: Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, USA.
Title: Hyperhomocysteinemia. An emerging and important risk factor for thromboembolic and cardiovascular disease [Review] [94 refs]
Source: American Journal of Clinical Pathology. 106(6)709-22, 1996 Dec. [see comments] [published errata appear in Am J Clin Pathol 1997 May;107(5)621 and 1997 Jun;107(6)715].
Abstract: Homocysteine is an important contributing factor to thrombosis, vascular injury, and vascular disease. Mechanisms for homocysteine-induced vascular disease include alterations in coagulation as well as endothelial cell and vessel wall injury. Hyperhomocysteinemia (HH[e]) can occur when homocysteine metabolism is altered by mutations in enzymes responsible for homocysteine metabolism. Characterization of these mutations identifies patient groups at risk for vascular disease. Treatment of HH(e) consists of vitamins and raises the possibility that some forms of vascular disease may be easily, safely, and inexpensively treated. [References: 94]
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Unique Identifier 96172866
Authors: den Heijer M. Koster T. Blom HJ. Bos GM. Briet E. Reitsma PH. Vandenbroucke JP. Rosendaal FR.
Institution: Department of Hematology, Municipal Hospital Leyenburg, The Hague, Netherlands.
Title: Hyperhomocysteinemia as a risk factor for deep-vein thrombosis
Source: New England Journal of Medicine. 334(12) 759-62, 1996 Mar 21. [see comments]. Comment in: N Engl J Med 1996 Sep 26;335(13)974-5; discussion 975-6, Comment in: N Engl J Med 1996 Sep 26;335(13)975; discussion 975-6
Abstract: BACKGROUND. Previous studies have suggested that hyperhomocysteinemia may be a risk factor for venous thrombosis. To assess the risk of venous thrombosis associated with hyperhomocysteinemia, we studied plasma homocysteine levels in patients with a first episode of deep-vein thrombosis and in normal control subjects. METHODS. We measured plasma homocysteine levels in 269 patients with a first, objectively diagnosed episode of deep-vein thrombosis and in 269 healthy controls matched to the patients according to age and sex. Hyperhomocysteinemia was defined as a plasma homocysteine level above the 95th percentile in the control group (18.5 micromol per liter). RESULTS. Of the 269 patients, 28 (10 percent) had plasma homocysteine levels above the 95th percentile for the controls, as compared with 13 of the controls (matched odds ratio, 2.5; 95 percent confidence interval, 1.2 to 5.2). The association between elevated homocysteine levels and venous thrombosis was stronger among women than among men and increased with age. The exclusion of subjects with other established risk factors for thrombosis (e.g., a deficiency of protein C, protein S, or antithrombin; resistance to activated protein C; pregnancy or recent childbirth; or oral-contraceptive use) did not materially affect the risk estimates. CONCLUSIONS. High plasma homocysteine levels are a risk factor for deep-vein thrombosis in the general population.
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