Homocysteine: The Rubik's cube of cardiovascular risk factors

Abstract

What can we conclude from these data? Clearly, elevated homocysteine levels are associated with an increased risk of CV events, but B vitamins may not provide a preventive benefit in patients with mild homocysteinemia. Future studies must take into account renal function when evaluating the pathogenicity of homocysteine, as well as therapies for reducing homocysteine levels other than B vitamins (eg, novel future therapies, as well as various combinations of exercise training, methionine restriction, and use of betaine-homocysteine methyltransferase and N-acetylcysteine). Homocysteine, however, remains an important field of study as an unconventional risk factor, one facet of a complex metabolic puzzle - a veritable Rubik's cube - that promotes atherosclerosis. © 2008 Mayo Foundation for Medical Education and Research.