Homocysteine and Non-Cardiac Vascular Disease.
Elevated homocysteine (Hcy) levels are predictors of cardiovascular disease (CVD). Hyperhomocysteinemia has also been associated with total and CVD mortality. However, whether Hcy is just a marker or plays a causal role in CVD remains to be elucidated. In this narrative review, we discuss the associations between Hcy and non-cardiac vascular diseases, namely stroke, peripheral artery disease (PAD), carotid artery disease, chronic kidney disease (CKD), atherosclerotic renal artery stenosis (ARAS), abdominal aortic aneurysm (AAA) and erectile dysfunction (ED). The effects of several drugs on Hcy levels are also considered. Folic acid, vitamin B6 and B12 supplementation can significantly decrease circulating Hcy concentrations but their effects on CVD risk reduction are conflicting. No current guidelines recommend the routine screening of Hcy levels in patients with non-cardiac vascular diseases. Therefore, further research is needed to elucidate the use of Hcy in the clinical practice.
Second Propedeutic Department of Internal Medicine, Medical School, Aristotle; University of Thessaloniki, Hippocration Hospital, Thessaloniki. Greece.
Niki
N
Katsiki
Lipid and Atherosclerosis Unit, Department of Internal Medicine, IMIBIC/Reina Sofia University Hospital/ University of Cordoba, Cordoba, Spain; CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid. Spain.
Pablo
P
Perez-Martinez
Dept. of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free Hospital Campus, University College London Medical School, University College London (UCL), Pond Street, London NW3 2QG. United Kingdom.
Dimitri P
DP
Mikhailidis
D000818:Animals; D050197:Atherosclerosis / Q000097:blood / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis; D002340:Carotid Artery Diseases / Q000097:blood / Q000175:diagnosis; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood* / Q000175:diagnosis*; D058729:Peripheral Arterial Disease / Q000097:blood / Q000175:diagnosis; D014652:Vascular Diseases / Q000097:blood* / Q000175:diagnosis*
D015415:Biomarkers; D006710:Homocysteine
Homocysteine; carotid artery disease; chronic kidney disease; erectile dysfunction; peripheral artery disease; stroke; vitamin B.