The role of homocysteine in thrombogenesis and atherogenesis. Possibilities and perspectives of correction with vitamins

Over the recent decade the role of homocysteine as risk factor of cardiovascular diseases has been subjected to profound investigation. Meta analyses have shown that in subjects with hyperhomocysteinemia venous thromboses have occurred 2,8-2,95 times more frequently as compared to those with normal values of homocysteine. Elevated levels of homocysteine have been reported in patients with arterial thromboses and pulmonary artery thromboembolism. Close relation between high level of homocysteine and enhanced platelet aggregation, its prooxidant action, ability to inhibit growth of endothelial cells constituted basis for proposal of homocysteine theory of atherosclerosis. The use of folate and vitamins B-6 and B-12 as homocysteine reducing therapy has been also suggested. Efficacy of this intervention was confirmed in experimental and clinical studies and in a multicenter European trial. These data allow to suppose that actual protection against progression of vascular pathology is possible.