Association Between Increased Homocysteine Levels and Impaired Fibrinolytic Potential: Potential Mechanism for Cardiovascular Risk

Geoffrey H. Tofler; Ralph B. D’Agostino; Paul F. Jacques; Andrew G. Bostom; Peter W. F. Wilson; Izabela Lipinska; Murray A. Mittleman; Jacob Selhub

doi:10.1055/s-0037-1613305

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2002; 88(05): 799-804
DOI: 10.1055/s-0037-1613305

Review Article

Schattauer GmbH

Association Between Increased Homocysteine Levels and Impaired Fibrinolytic Potential: Potential Mechanism for Cardiovascular Risk

Authors

Geoffrey H. Tofler

¹Royal North Shore Hospital, Australia
Ralph B. D’Agostino

²Boston University Department of Mathematics
Paul F. Jacques

³USDA Human Nutrition Research Center on Aging at Tufts University
Andrew G. Bostom

³USDA Human Nutrition Research Center on Aging at Tufts University
Peter W. F. Wilson

⁴National Heart, Lung and Blood Institute’s Framingham Heart Study
Izabela Lipinska

⁵Beth Israel Deaconess Medical Center
Murray A. Mittleman

⁵Beth Israel Deaconess Medical Center
Jacob Selhub

³USDA Human Nutrition Research Center on Aging at Tufts University

Abstract

Summary

Background

Elevated homocysteine levels increase cardiovascular risk although the mechanism is not well understood. Since thrombosis plays an important role in plaque development and acute coronary syndromes, hyperhomocysteinemia may increase risk by increasing the thrombotic potential.

Methods and Results

Hemostatic risk factors were measured in 3216 individuals (1451 men and 1765 women) free of cardiovascular disease who participated in cycle 5 of the Framingham Offspring Study. An increase in homocysteine level was associated with a rise in plasminogen activator inhibitor (PAI-1), tissue plasminogen activator (TPA) antigen, von Willebrand factor and fibrinogen level. After regression analyses adjusting for covariates, there remained significant associations between homocysteine and PAI-1 and TPA antigen.

Conclusion

Increasing homocysteine levels are associated with impaired fibrinolytic potential, as indicated by increased PAI-1 and TPA antigen levels. These data suggest that folic acid and other homocysteine lowering therapies may decrease cardiac events through a reduction in thrombotic tendency.

Keywords

Homocysteine - cardiovascular disease - thrombosis

Full Text

References

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