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Elevated homocysteine levels are listed among risk factors for angina. How is homocysteine related to the heart? Or the coronary arteries? How do these relationships make it a risk factor for angina? enter image description here

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In his answer to a related question Alan Boyd has given the mechanism how homocysteine inhibited (1)Protein C activation and the (2)binding of free thrombin, both ways promoting coagulation and thrombosis. According to the answer of Xaqron below there are further mechanisms. Not all of them are linked to angina yet. – winerd May 27 '13 at 8:04


  1. Causes endothelial dysfunction and damage
  2. Accelerates thrombin formation
  3. Inhibits native thrombolysis
  4. Promotes lipid peroxidation through free radical formation
  5. Induces vascular smooth muscle proliferation
  6. Promotes monocyte chemotaxis

Many observational epidemiological studies indicate that individuals with higher Homocysteine levels have increased risks of cardiovascular disease.

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How can the effects on lipid peroxidation, smooth muscle proliferation and monocytes lead to angina? – winerd May 11 '13 at 19:03
@winerd: No, if it accelerates thrombus formation then it would be more dangerous. I meant thrombin formation as already said in answer. – Xaqron May 11 '13 at 19:37
@winerd: Mechanism is unknown at the time but these factors make a good basis for thrombus formation. Your questions are more medical than biologic, consider voting on Medicine in area51 – Xaqron May 11 '13 at 19:46
@Xaqron I'd say this is on topic for us. I can see how the factors you've listed would be clear risk factors for myocardial infarction but, with the possible exception of 5, I'm not seeing a clear link to Angina (stable or otherwise). Could you elaborate further? – Rory M May 11 '13 at 22:39
@RoryM: Smooth muscle proliferation => lower internal diameter of vessels. – Xaqron May 11 '13 at 22:49

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