Abstract
Homocysteine (Hcy) is metabolized through two pathways, requiring folates and B6-12 vitamins as cofactors. Increased Hcy concentration is responsible for early atherosclerosis with possible acute cardiovascular events. Ample evidence has demonstrated that Hcy lowering with folic acid and B vitamin supplementation, even if reduces Hcy serum levels, is unable to lower cardiovascular risk. On the contrary, omega-3 fatty acids and some nutraceuticals, such as N-acetyl cysteine, taurine, or S-adenosyl-methionine, reduce both Hcy serum concentration and cardiovascular risk. Instead, antiplatelet drugs, such as aspirin and clopidogrel or ticlopidine and statins only antagonize vascular derangements. Finally, metformin, some lipid-lowering drugs, and some diuretics should be avoided because they can increase Hcy levels.
MeSH terms
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Acetylcysteine / administration & dosage*
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Aspirin / adverse effects
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Blood Vessels / drug effects
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Blood Vessels / pathology
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Cardiovascular Diseases / blood
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Cardiovascular Diseases / pathology
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Cardiovascular Diseases / prevention & control*
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Clopidogrel
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Diuretics / adverse effects
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Fatty Acids, Omega-3 / administration & dosage*
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Folic Acid / administration & dosage
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Homocysteine / blood*
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Humans
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Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects
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Hypoglycemic Agents / adverse effects
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Metformin / adverse effects
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Platelet Aggregation Inhibitors / adverse effects
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S-Adenosylmethionine / administration & dosage*
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Ticlopidine / adverse effects
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Ticlopidine / analogs & derivatives
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Vitamin B 12 / administration & dosage
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Vitamin B 6 / administration & dosage
Substances
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Diuretics
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Fatty Acids, Omega-3
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Hydroxymethylglutaryl-CoA Reductase Inhibitors
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Hypoglycemic Agents
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Platelet Aggregation Inhibitors
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Homocysteine
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S-Adenosylmethionine
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Vitamin B 6
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Metformin
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Folic Acid
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Clopidogrel
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Ticlopidine
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Vitamin B 12
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Aspirin
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Acetylcysteine