Hyperhomocysteinemia in arterial or venous thrombosis: a retrospective study of 75 patients

OBJECTIVE: Previous studies suggest that hyperhomocysteinemia may be a risk factor for arterial and venous thrombosis. We retrospectively analyzed dat a from 75 patients with thrombosis. PATIENTS AND METHODS: Thirty-four patients had arterial thrombosis, 22 veno us thrombosis and 19 venous and arterial thrombosis. Of the 75 patients (49 men and 26 women, mean age 49 +/- 15 years) about: two-thirds had recurren t episodes of thrombosis. RESULTS: Hyperhomocysteinemia was defined as serum homocysteine level above 14.1 mu mol/l (mean + 2.7 SD in healthy subjects) and was found in 67 pati ents (89%, CI95% = 80 - 95). Mean total homocysteine concentration was 21.6 +/- 13.6 mu mol/l for the 75 patients. About half of the patients were smo kers, 35% had hypertension and 25% high serum cholesterol. There was no sig nificant relationship between serum homocysteine level and smoking status, hypertension or serum cholesterol level. Ten patients (13%, CI95% = 7 - 23) had low serum cobalamin (< 150 pmol/l). Serum folates were less than or eq ual to 10 nmol in 41% of the patients in the arterial thrombosis group (CI9 5% = 25 - 59), in 27% in the venous thrombosis group (CI95% = 11 - 50), and in 31% in the arterial and venous thrombosis group (CI95% = 13 - 57), Thir teen patients received vitamin B supplementation. Hyperhomocysteinemia decr eased in 12/13 patients (CI95% = 64 - 100) and returned to normal values in 9/13 patients (69%, CI95% = 38 -91). CONCLUSION: Our data show that hyperhomocysteinemia is frequently found in arterial and venous thrombosis. Further studies are needed to determine the clinical impact of homocysteine lowering therapy.