Relation of serum homocysteine and lipoprotein(a) concentrations to atherosclerotic disease in a prospective Finnish population based study

LP(a) phenotypes and levels in angiographically proven coronary heart disease patients and controls

“…The association between high plasma concentrations of Lp(a) and CAD is in agreement with findings in some nested case-control studies (12,16) and two recent prospective studies (18)(19)(20)(21), whereas other studies with similar design did not support such an association (14).…”

Homocysteine, hypertension and stroke

“…For proponents of the homocysteinestroke hypothesis it was somewhat disconcerting that the two prospective studies included in this meta-analysis, both based on a nested case-control design, were negative. 18,19 In the US physicians study a weak non-significant association was observed between total homocysteine concentrations and ischaemic stroke 19 and in a propective study from the North Karelia Project, no association with either myocardial infarction or stroke was observed. 18 It should be emphasised however that these studies may have lacked power to address the homocysteine-stroke hypothesis as both were based on populations with relatively few individuals in the upper tail of the skewed tHcy distribution.…”

“…13 There are additional concerns regarding unmeasured and residual confounding due to dietary and other lifestyle factors associated with hyperhomocysteinaemia. 14,15 The findings from the small number of prospective studies that have addressed associations between tHcy concentrations and incident coronary heart diseases (CHD) or stroke are inconsistent [16][17][18][19][20][21][22] Homozygosity for a defective thermolabile variant of MTHFR, a common genetic polymorphism which results in hyperhomocysteinemia, has not been consistently linked with cardiovascular disease endpoints. 23,24 Although the importance of gene markers will vary depending on relevant environmental exposures, diet in this instance, the findings from gene association studies conducted to-date are distinctly unimpressive.…”

Low serum folate concentrations are associated with an excess incidence of acute coronary events: the Kuopio Ischaemic Heart Disease Risk Factor Study

“…This association has been con®rmed in some, but not in all prospective studies (Stampfer et al, 1992;Verhoef et al, 1994;Perry et al, 1995;Arnesen et al, 1995;Folsom et al, 1998;Wald et al, 1998;Alfthan et al, 1994;Evans et al, 1997). In a cross-country study with WHO MONICA data (Alfthan et al, 1997) high plasma tHcy concentrations were associated with increased cardiovascular mortality, and both the mean plasma tHcy concentration and cardiovascular mortality were the highest in Finland.…”