Contact Person

Dr. Elinor Switzer

Managing Editor

Phone: +49 (0)711 - 2 29 87 63
Fax: +49 (0)711 - 2 29 87 65
send an Email


The risk of venous and arterial thrombosis in hyperhomocysteinaemia is low and mainly depends on concomitant thrombophilic defects

Journal: Thrombosis and Haemostasis
ISSN: 0340-6245

New concepts in vascular biology (Part I)

Issue: 2007: 98/2 (Aug) pp. 259-481
Pages: 457-563

The risk of venous and arterial thrombosis in hyperhomocysteinaemia is low and mainly depends on concomitant thrombophilic defects

Willem M. Lijfering1, Michiel Coppens2, Marlène H. W. van de Poel1, Saskia Middeldorp2, Karly Hamulyák3, Ivan Bank2, Nic J. G. M. Veeger1, Martin H. Prins4, Harry R. Büller2, Jan van der Meer1
1Division of Haemostasis, Thrombosis and Rheology, Department of Hematology, University Medical Center Groningen, Groningen, The Netherlands; 2Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands; 3Department of Hematology, University Hospital Maastricht, Maastricht, The Netherlands; 4Department of Clinical Epidemiology and Medical Technology Assessment, University Hospital Maastricht, Maastricht, The Netherlands.


Risk Factors, thrombophilia, Venous thrombosis, clinical studies, Arterial thrombosis


As homocysteine-lowering treatment has not reduced the risk of recurrent thrombosis in recent clinical trials,we hypothesized that mild hyperhomocysteinaemia is an epiphenomenon or associated with a low absolute risk of thrombosis. In this retrospective study, we enrolled 478 evaluable first-degree relatives of consecutive patients with venous thrombosis or premature atherosclerosis, and hyperhomocysteinemia. Absolute risks of thrombosis and effects of concomitant thrombophilic defects were compared. Relative risks were adjusted for clustering in families, age, sex, and atherosclerotic risk factors, where appropriate. Annual incidence of venous thrombosis was 0.16% (95% confidence interval [CI], 0.08–0.30) in hyperhomocysteinemic relatives versus 0.11% (CI, 0.05–0.20) in normohomocystei- nemic relatives; adjusted relative risk 1.6 (CI, 0.6–4.5). Annual incidences of arterial thrombosis were 0.34% (CI, 0.21–0.52) and 0.24% (CI, 0.15–0.37) in hyperhomocysteinemic and normohomocysteinemic relatives, respectively; adjusted relative risk 1.5 (CI, 0.6–3.5). Concomitance of multiple thrombophilic risk factors increased the risk of venous thrombosis in hyperhomocysteinemic relatives 20 fold, but a comparable effect was demonstrated in normohomocysteinemic relatives. We conclude that hyperhomocysteinaemia is associated with a low absolute risk of venous and arterial thrombosis. Concomitant thrombophilic defects are probably main determinants on the risk of venous thrombosis, rather than hyperhomocysteinaemia itself.

You may also be interested in...


Online Supplementary Material

Philip C. Bennett1,2; Stanley H. Silverman2; Paramjit S. Gill3; Gregory Y. H. Lip1

Thromb Haemost 2009 101 6: 1032-1040

R. B. Zotz

Hämostaseologie 2008 28 3: 120-129

Martin J. O’Donnell1, Simon McRae1, Susan R. Kahn2, Jim A. Julian1, Clive Kearon1, Betsy MacKinnon1, Debbie Magier3, Carla Strulovich2,Theresa Lyons1, Sandra Robinson3, Jack Hirsh1, Jeffrey S. Ginsberg1,2

Thromb Haemost 2008 99 3: 623-629