Plasma Homocyst(e)ine Concentrations in Cerebrovascular Disease

Abstract

To the Editor: We read with interest the article, “Plasma Homocyst(e)ine Concentration, but Not MTHFR Genotype, Is Associated With Variation in Carotid Plaque Area.”1 The authors showed that compared with reference control subjects, homocysteine concentrations were increased (13.7±0.73 versus 10.6±5.6 μmol/L) in 307 patients (148 women, 159 men) with stenotic artery disease (as indicated by carotid plaque area in 2D ultrasound). They observed a strong association between extent of carotid artery disease and homocysteine concentrations but not with the termolabile mutation (677T) in the gene encoding the methylenetetrahydrofolate reductase ( MTHFR ). Thus, their observations are in accordance with earlier reports.2 We would like to comment on 2 points. First, recently we differentially investigated homocysteine concentrations in 144 patients (55 females, 89 males) with cerebral large-vessel disease (plaques or stenoses of the extracranial arteries and/or increase of cerebral blood flow velocity of ≥140 cm/s in the large intracranial vessels) …