Cost-effectiveness of Vitamin Therapy to Lower Plasma Homocysteine Levels for the Prevention of Coronary Heart Disease

Abstract
In 1969, McCully1 proposed homocysteine as an etiologic agent in the pathogenesis of vascular disease. Over the past decade, at least 10 large prospective cohort studies have published data demonstrating a statistically significant association of basal homocysteine levels with coronary heart disease (CHD) events and death.2-11 Nygard et al11 reported that patients with known CHD had a 1.6- to 2.5-fold increase in mortality per each 5-µmol/L (0.68-mg/L) increase in fasting total homocysteine.