Photo Credit: Nemes Laszlo

The following is a summary of “Association between homocysteine levels and mortality in CVD: a cohort study based on NHANES database,” published in the November 2024 issue of Cardiology by Liu et al.     

Cardiovascular disease (CVD) is a major global health concern, with only 50% of cases explained by traditional risk factors. The role of homocysteine (Hcy) as a potential risk factor remains debated.  

Researchers conducted a prospective cohort study to examine the association between Hcy levels and mortality in patients with CVD.  

They analyzed National Health and Nutrition Examination Survey (NHANES) 1999–2006 data, using Cox proportional hazards regression and restricted cubic splines to assess the relationship between Hcy levels and mortality, adjusting for covariates.  

The result showed 1,739 participants (median follow-up: 126 months), and 1,194 died, including 501 from CV causes. The hazard ratios (HR) for CVD mortality at different Hcy levels were 1.26 (0.92, 1.73) for T2 (9.3–12.5 µmol/L) and 1.69 (1.14, 2.51) for T3 (>12.5 µmol/L) (P for trend = 0.0086). The HR for all-cause mortality was 1.22 (1.05, 1.42) for T2 and 1.64 (1.29, 2.09) for T3 (P for trend < 0.0001). Elevated Hcy levels were associated with higher risks of all-cause and CV mortality. A nonlinear relationship was observed, with inflection points at 14.5 µmol/L for all-cause mortality and 14.6 µmol/L for CV mortality. Subgroup analyses showed interactions with age, vitamin B12 levels, and smoking.  

They concluded that elevated Hcy levels were associated with increased risks of both all-cause and CV mortality in patients with CVD.  

Source: bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-024-04317-9