Homocysteine: is it a clinically important cardiovascular risk factor?

Elevated plasma homocysteine is associated with an increased risk of myocardial infarction, stroke, and venous thromboembolism. Folic acid and other B vitamins lower plasma homocysteine levels, but whether this therapy confers a clinical benefit has yet to be determined. Until we know the results of ongoing clinical trials of homocysteine-lowering therapy, testing for and treating elevated homocysteine is probably justified only in patients with known cardiovascular disease or who are at high risk.