Association between increased homocysteine levels and impaired fibrinolytic potential: potential mechanism for cardiovascular risk

Thromb Haemost. 2002 Nov;88(5):799-804.


Background: Elevated homocysteine levels increase cardiovascular risk although the mechanism is not well understood. Since thrombosis plays an important role in plaque development and acute coronary syndromes, hyperhomocysteinemia may increase risk by increasing the thrombotic potential.

Methods and results: Hemostatic risk factors were measured in 3,216 individuals (1,451 men and 1,765 women) free of cardiovascular disease who participated in cycle 5 of the Framingham Offspring Study. An increase in homocysteine level was associated with a rise in plasminogen activator inhibitor (PAI-1), tissue plasminogen activator (TPA) antigen, von Willebrand factor and fibrinogen level. After regression analyses adjusting for covariates, there remained significant associations between homocysteine and PAI-1 and TPA antigen.

Conclusion: Increasing homocysteine levels are associated with impaired fibrinolytic potential, as indicated by increased PAI-1 and TPA antigen levels. These data suggest that folic acid and other homocysteine lowering therapies may decrease cardiac events through a reduction in thrombotic tendency.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / etiology*
  • Female
  • Fibrinolysis / physiology*
  • Hemostasis / physiology
  • Homocysteine / blood*
  • Humans
  • Male
  • Middle Aged
  • Plasminogen Activator Inhibitor 1 / blood
  • Risk Factors
  • Tissue Plasminogen Activator / blood


  • Biomarkers
  • Plasminogen Activator Inhibitor 1
  • Homocysteine
  • Tissue Plasminogen Activator