title: Both vitamin B6 and total homocysteine plasma levels predict long-term atherothrombotic events in healthy subjects.
abstract: OBJECTIVE
  The contribution of homocysteine and group B vitamins in determining cardiovascular risk is debated. We assessed the predictive value of total homocysteine (tHcy), vitamin B12, folate, and vitamin B6 on the long-term occurrence of coronary and cerebral atherothrombotic events in a nested case-control study.
  
  
  RESULTS
  Within a cohort of 1021 healthy subjects (490 men and 531 women) recruited in 1987, 66 first-ever coronary and 43 first-ever cerebrovascular events were recorded at a 12-year follow-up (cases, n=109). A total of 109 control subjects (remaining free from events) were matched with cases according to age, sex, smoking, hypertension, dyslipidaemia, and body mass index. Serum samples obtained in 1987 at baseline were used to measure tHcy, folate, and vitamins B12 and B6, as well as C-reactive protein plasma concentrations. We found a significant graded association between tHcy levels and the risk of coronary and cerebrovascular events [odds ratio (OR) for uppermost vs. lowermost quartile=1.34, 95% CI 1.01-1.76)]. Folate and vitamin B12 did not significantly differ between cases and controls, but were negatively (P<0.01) correlated with tHcy. Vitamin B6 did not correlate with tHcy levels, but differed significantly between cases and controls: for subjects in the uppermost quartile vs. the lowermost quartile of vitamin B6, OR=0.69 (95% CI 0.49-0.98). For subjects in the lowermost quartile of vitamin B6 and the uppermost quartile of tHcy, OR=17.50 (95% CI 1.97, 155.59). Cases and controls were not different as to C-reactive protein.
  
  
  CONCLUSIONS
  tHcy and plasma vitamin B6 are long-term independent risk factors for coronary and cerebrovascular events.
authors.affiliation: Cardiovascular Prevention Center, ASS 4 and Agenzia Regionale della Sanità del Friuli-Venezia Giulia, Udine, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Vanuzzo
authors.forename: Lorenza
authors.initials: L
authors.lastname: Pilotto
authors.forename: Rossana
authors.initials: R
authors.lastname: Lombardi
authors.forename: Guido
authors.initials: G
authors.lastname: Lazzerini
authors.forename: Marisa
authors.initials: M
authors.lastname: Carluccio
authors.forename: Silvia
authors.initials: S
authors.lastname: Diviacco
authors.forename: Franco
authors.initials: F
authors.lastname: Quadrifoglio
authors.forename: Giorgia
authors.initials: G
authors.lastname: Danek
authors.forename: Dario
authors.initials: D
authors.lastname: Gregori
authors.forename: Paolo
authors.initials: P
authors.lastname: Fioretti
authors.forename: Marco
authors.initials: M
authors.lastname: Cattaneo
authors.forename: Raffaele
authors.initials: R
authors.lastname: De Caterina
mesh_terms: D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000097:blood* / Q000209:etiology; D003328:Coronary Thrombosis / Q000097:blood* / Q000209:etiology; D005260:Female; D006710:Homocysteine / Q000378:metabolism*; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000097:blood* / Q000209:etiology; D020767:Intracranial Thrombosis / Q000097:blood* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000209:etiology; D025101:Vitamin B 6 / Q000378:metabolism*
chemical_list: D006710:Homocysteine; D025101:Vitamin B 6; D002097:C-Reactive Protein