Homocysteine and atherothrombosis

摘要: Atherosclerosis with or without thrombosis superimposed is the most frequent cause of ischemic heart disease (IHD), peripheral arterial disease, and a main stroke. Conflicting results have been reported in genetic, observational, experimental studies on relationship between homocysteine these atherothrombotic diseases. Although cardiovascular complications are common homocystinuric patients (severe hyperhomocysteinemia), IHD, manifestation atherothrombosis general population, appears to be rare. On basis findings individuals hyperhomocysteinemia genetic origin, there fact no clear evidence for causal role pathogenesis positive association plasma IHD observed many, but not all epidemiologic does prove causality. To infer causality from observational studies, should temporal, consistent, strong, independent, graded (dose-response effect), duration-dependent exposure outcomes, biologically plausible mechanism exist. The levels fulfill criteria beyond reasonable doubt. In great extent determined by dietary habits, could marker, consequence, and/or risk-associated behavior (e.g., diet low fruits vegetables) rather than atherothrombosis. Experimentally, itself atherogenic normal animals relatively cholesterol levels. theory atherosclerosis tested more thoroughly hypercholesterolemic that develop spontaneously determine whether elevated harmful under conditions. A remains established.