Background: Elevated levels of homocysteine (HCY) are associated with arterial and venous thrombosis via several mechanisms such as increased tissue factor expression, enhanced platelet reactivity, increased thrombin generation, and endothelial dysfunction
Aims: To evaluate if hyper HCY (hHCY) may be considered as an independent thrombosis risk factor and its incidence in different sites of thrombosis
Methods: We retrospectively analysed clinical data of 319 patients, 184 with hHCY and 135 with normal HCY (nHCY), followed by our centre during the last 5 years. We excluded other conditions of thrombophilia: Factor V Leiden and Prothrombin G20210, Protein C and S deficiency, presence of anticardiolipin or anti-beta2 glycoprotein-I antibodies and lupus anticoagulant
Results: 29/184 with hHCY were found with thrombosis. Of these: 18/29 (62.1%) had venous thrombosis (DVT), 11/29 (37.9%) had arterial thrombosis. We considered three hHCY severity levels: mild 15-29 μmol/L, moderate 30-100 μmol/L and severe>100 μmol/L. 22/135 (16.3%) nHCY patients were diagnosed with thrombosis. Of these: 17/135 (12.6%) had DVT and 5/135 arterial thrombosis (3.7%). Even in this case, we observed more DVT (17/22,77.3%) than arterial thrombosis (5/22,22.7%). The comparison about incidence of thrombosis between hHCY and nHCY groups evidenced similar percentages (15.8% and 16.3% respectively). Results are resumed in table 1. We found different thrombosis percentages comparing the subjects with normal and mild hHCY to those with moderate hHCY: people with moderate hHCY had a much higher percentage of arterial thrombosis (61.5%) than those with nHCY (22.7%) and patients with mild hHCY (15.8%) (see table 2), even if these data were not sufficient to hypothesize a correlation between levels of HCY and sites of thrombosis
Conclusion(s): Our analysis did not demonstrate that hHCY can be considered an independent risk factor for thrombosis. In our opinion, as reported by other authors, hHCY could be only considered as a prothrombotic cofactor
Tab.1: correlation between different sites of thrombosis and homocysteine levels.
Tab.2 Thrombosis cases and frequency in patients with and without hyperhomocysteinemia
To cite this abstract in AMA style:
Sottilotta G, Nicolò G. Homocysteine as an independent thrombosis risk factor [abstract]. https://abstracts.isth.org/abstract/homocysteine-as-an-independent-thrombosis-risk-factor/. Accessed March 22, 2024.« Back to ISTH 2022 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/homocysteine-as-an-independent-thrombosis-risk-factor/