Hyperhomocysteinemia - is significant risk factor arterial and venosis trombosis development

Hyperhomocysteinemia (HHcy) is an established risk factor for both arterial and venous thrombosis, arising from the interaction of genetic and environmental factors. Concerning Russia there are very limited data on this problem. We studied 84 unrelated patients with documented thrombotic diseases and 30 age and sex matched controls in order to evaluate the significance of HHcy and MTHFR genotype in arterial and venous thrombosis in the population of North Western Russia. We showed HHcy significantly more prevalent in patients than controls. A significant association between HHcy and recurrent thrombosis was also observed. Hcy levels were raised in cigarette smoking patients with a high caffeine intake, an effect further pronounced in subjects with coexistent C677T substitution. After supplementation by folic acid Hcy levels significantly reduced in all patients. Our study demonstrates HHcy to be a frequent and independent risk factor for thrombotic complications and their recurrences in the population of North Western Russia. We recommend that patients with idiopathic and particularly recurrent thrombosis would benefit from tHcy determinations in diagnostic thrombophilia screening strategies. Additionally, we consider that routine MTHFR polymorphism screening offers a good opportunity to identify individuals at increased risk of developing HHcy. Importantly HHcy is easily reversible in the majority of cases by improved patient awareness and vitamin supplementation.