Hyperhomocysteinemia

Elevated plasma homocysteine may be an independent risk factor for coronary artery disease. Elevated levels can be reduced with folate and pyridoxine treatment and with smoking cessation (although not smoking reduction), but their clinical significance is unknown. Randomized trials of
vitamin supplementation in patients with prior cardiovascular disease have generally yielded negative results. At this time, there is insufficient evidence to justify screening for elevated serum homocysteine, but patients should be encouraged to maintain an adequate dietary intake of
folate, pyridoxine (vitamin B6), and vitamin B12.