Homocysteine and Cardiovascular Diseases

To the Editor: Malinow et al,1 in their recent review on homocysteine and cardiovascular diseases, correctly state that based on the available evidence, it is premature to conclude that total homocysteine (tHcy) plasma levels are predictive of the development of cardiovascular events. Their conclusion is mostly based on the analysis of the results of prospective cohort studies of tHcy in cardiovascular diseases, which were conflicting. In my opinion, among the possible explanations for the different results of prospective cohort studies, the effects of different cardiovascular risk profiles among the populations studied should be considered. Therefore, when analyzing the results of prospective cohort studies …