Alastair Compston: Charcot Prize winner, 2007

详细信息    查看全文

• 作者：James Butcher
• 关键词：veins ; varicose veins ; matrix metalloproteinases ; venous remodeling
• 刊名：Lancet Neurology
• 出版年：2007
• 出版时间：August 2007
• 年：2007
• 卷：6
• 期：8
• 页码：672
• 全文大小：51 K

文摘

On the basis of the results of several recent clinical trials, many researchers have concluded that vitamin therapy designed to lower total homocysteine concentrations is not effective in reducing the risk of cardiovascular events. However, whereas almost all myocardial infarctions are due to plaque rupture, stroke has many more pathophysiological mechanisms, and thrombosis—which is increased by raised total homocysteine concentrations—has an important role in many of these processes. Thus, stroke and myocardial infarction could respond differently to vitamin therapy. A detailed assessment of the results of the recent HOPE-2 trial and a reanalysis of the VISP trial restricted to patients capable of responding to vitamin therapy suggest that higher doses of vitamin B12 and perhaps new approaches to lowering total homocysteine besides routine vitamin therapy with folate, vitamin B6, and vitamin B12 could reduce the risk of stroke. Thus, therapy to lower homocysteine could still help to prevent stroke, if not other vascular outcomes.