Association Between Homocysteine Levels And All-cause Mortality

[Mito]

http://twin.sci-hub.ac/68225acb9de5a6d1f3a7d3c2a5102cf2/fan2017.pdf

It is important to explore whether Hcy levels were correlated with all-cause mortality. In the current meta-analysis, we identied that elevated Hcy levels were associated with the risk of all-cause mortality. Furthermore, the dose-response meta-analysis showed a linear association between Hcy levels and all-cause mortality risk, and each 5 μmol/L increment of Hcy corresponded to a 33.6% increase in risk of all-cause mortality.

 

[Mito]

Elevated Homocysteine Intensify the Effect of Lipoprotein(a) on Stroke Recurrence

Lipoprotein(a) (Lp[a]) is a unique liver‐derived lipoprotein with primarily genetically determined concentrations that contributes to cardiovascular disease via multiple mechanisms. Evidence from observational and genetic studies support a causal role of Lp(a) in the acute ischemic stroke (AIS), especially in the atherosclerosis subtype.1 Plasma total homocysteine (tHcy) is a methionine intermediate metabolite. Despite the controversy, tHcy has been recognized as a risk factor for AIS. Furthermore, tHcy showed great impact on Lp(a) binding to plasmin‐modified fibrin and augmented the interaction between Lp(a) and Macrophage‐1 antigen integrin, which might intensify the proatherogenic, prothrombotic, and proinflammatory pathway mediated by Lp(a). Several past studies showed that Lp(a) and tHcy had an interaction effect on the occurrence of coronary artery disease and retinal arteriosclerosis, and both are atherosclerosis diseases.2 Therefore, we aimed to examine the effect of Lp(a) on stroke recurrence within 1 year in patients with AIS or transient ischemic attack (TIA), with and without elevated baseline tHcy.

https://www.ahajournals.org/doi/10.1161/JAHA.122.026707