Meta-analysis of Hyperhomocysteinemia as a Risk Factor for Venous Thromboembolic Disease

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Abstract
A POSITIVE association exists between hyperhomocysteinemia (hyper-Hcy) and the development of premature atherosclerosis.1 A meta-analysis1 of arteriosclerosis and hyper-Hcy included 25 case-control and cross-sectional studies. The summary odds ratios (ORs) from this overview1 were 1.7 (95% confidence interval [CI], 1.5-1.9) for coronary artery disease, 2.5 (95% CI, 2.0-3.0) for cerebrovascular disease, and 6.8 (95% CI, 2.9-15.8) for peripheral vascular disease. Limitations of these findings include substantial heterogeneity between studies, the omission of both published and unpublished data,2 and the inclusion of patients with chronic renal insufficiency, for example, a state that may dramatically elevate homocysteine (Hcy) levels.3,4