ABSTRACT
In this chapter, we will consider the relationship between hyperhomocyst(e)inemia and carotid atherosclerosis, a common cause of ischemic stroke. The metabolism of homocyst(e)ine will be reviewed with emphasis on the contribution of vitamin co-factors needed for the enzymatic conversion of the base molecule into inactive species. The role of homocyst(e)ine in the pathogenesis of atherosclerosis and prothrombotic conditions will then be considered. A survey of investigations reporting an association between hyperhomocyst(e)inemia and carotid atherosclerosis will be presented. The chapter will conclude with a discussion of clinical trials that have been performed to date for attempted treatments of hyperhomocyst(e)inemia with comments on the implications for the management of carotid atherosclerosis.
