title: Association between increased homocysteine levels and impaired fibrinolytic potential: potential mechanism for cardiovascular risk.
abstract: 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.
  
  
  RESULTS
  Hemostatic risk factors were measured in 3,216 individuals (1,451 men and 1,765 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Royal North Shore Hospital, St Leonards', NSW 2065, Australia. gtofler@doh.health.nsw.gov.au
authors.forename: Geoffrey H
authors.initials: GH
authors.lastname: Tofler
authors.forename: Ralph B
authors.initials: RB
authors.lastname: D'Agostino
authors.forename: Paul F
authors.initials: PF
authors.lastname: Jacques
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Bostom
authors.forename: Peter W F
authors.initials: PW
authors.lastname: Wilson
authors.forename: Izabela
authors.initials: I
authors.lastname: Lipinska
authors.forename: Murray A
authors.initials: MA
authors.lastname: Mittleman
authors.forename: Jacob
authors.initials: J
authors.lastname: Selhub
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology*; D005260:Female; D005342:Fibrinolysis / Q000502:physiology*; D006487:Hemostasis / Q000502:physiology; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D012307:Risk Factors; D010959:Tissue Plasminogen Activator / Q000097:blood
chemical_list: D015415:Biomarkers; D017395:Plasminogen Activator Inhibitor 1; D006710:Homocysteine; D010959:Tissue Plasminogen Activator