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proLékaře.cz / Journals / Athero Review / 2020 - 1

Homocysteine consensus

Czech version

Authors: Ján Lietava 1;  Pavel Blažíček 2;  Martin Čaprnda 1;  Katarína Rašlová 3;  Jana Tisoňová 4;  Branislav Vohnout 3,5,6
Authors‘ workplace: I. interná klinika LF UK a UNB, Nemocnica Staré Mesto, Bratislava 1;  Ústav chémie, klinickej biochémie a laboratórnej medicíny LF SZU v Bratislave 2;  Koordinačné centrum pre familiárne hyperlipoproteinémie, SZU v Bratislave 3;  Ústav farmakológie a klinickej farmakológie LF UK, Bratislava 4;  Ústav výživy, FOaZOŠ SZU v Bratislave 5;  Ústav epidemiológie LF UK v Bratislave 6
Published in: AtheroRev 2020; 5(1): 8-15
Category: Guidelines

Overview

Homocysteine consensus reflects current knowledge that homocysteine is rather a risk marker then a factor and treatment of hyperhomocysteinemia does not reduce cardiovascular morbidity and mortality. Panel of experts state this position to approach cardiovascular prevention and treatment in praxis.

A. General therapeutic intervention is not generally indicated based on current EBM data.

B. General screening of homocysteine is not clinically beneficial in both general population and in patients with cardiovascular disease.

  • Preventive administration of B group vitamins to reduce plasma homocysteine level in general population is not supported based on current EBM data. Population screening is not indicated – class III, level A.
  • Therapeutic administration of B group vitamins to reduce plasma homocysteine level in patients in secondary or tertiary prevention is not supported based on current EBM data. Population screening is not indicated – class III, level A.
  • There are no sufficient data on effect of measuring homocysteine on decision to start treating hypertension or dyslipidemias. Population screening is not indicated, only individual patients´ examination – class IIb, level A.

Keywords:

screening – cardiovascular prevention – homocysteine – vitamins group B

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