Is homocysteine a relevant cardiovascular risk factor?

Scientific research is searching constantly for new markers to help stage the progress and prognosis of cardiovascular disease. Over the past few decades, homocysteine has been suggested as a risk factor involved in the promotion of atherosclerosis and thrombotic vascular events. Several large observational studies have indicated a relationship between homocysteine and cardiovascular illness. However, more robust prospective trials reveal a weaker association between the two than do case-control and cross-sectional data. Recently, many randomized controlled trials have evaluated the impact of homocysteine-lowering therapy on vascular risk. The overall evidence suggests a null effect, thereby failing to validate the hypothesis that a reduction in homocysteine levels would result in clinical benefit. This review outlines the latest relevant data and illustrates why the use of homocysteine as a screening tool or a target of cardiovascular treatment cannot be recommended.