Meta-analysis of Hyperhomocysteinemia as a Risk Factor for Venous Thromboembolic Disease

Abstract

A POSITIVE association exists between hyperhomocysteinemia (hyper-Hcy) and the development of premature atherosclerosis.¹ A meta-analysis¹ of arteriosclerosis and hyper-Hcy included 25 case-control and cross-sectional studies. The summary odds ratios (ORs) from this overview¹ were 1.7 (95% confidence interval [CI], 1.5-1.9) for coronary artery disease, 2.5 (95% CI, 2.0-3.0) for cerebrovascular disease, and 6.8 (95% CI, 2.9-15.8) for peripheral vascular disease. Limitations of these findings include substantial heterogeneity between studies, the omission of both published and unpublished data,² and the inclusion of patients with chronic renal insufficiency, for example, a state that may dramatically elevate homocysteine (Hcy) levels.^3,4