Nonfasting Plasma Total Homocysteine Level and Mortality
Authors: Jeremy D. Kark, Joseph H. Abramson, Irwin H. Rosenberg
Journal: Annals of Internal Medicine (2000)

Letters2 May 2000Nonfasting Plasma Total Homocysteine Level and MortalityJeremy D. Kark, MD, PhD, Joseph H. Abramson, MB, BCh, and Irwin H. Rosenberg, MDJeremy D. Kark, MD, PhDHadassah Medical Organization and Hebrew University; Ein Kerem, Jerusalem 91120 (Kark)Hadassah Medical Organization and Hebrew University; Ein Kerem, Jerusalem 91120 (Abramson)Tufts University; Boston, MA 02111 (Rosenberg)Search for more papers by this author, Joseph H. Abramson, MB, BChHadassah Medical Organization and Hebrew University; Ein Kerem, Jerusalem 91120 (Kark)Hadassah Medical Organization and Hebrew University; Ein Kerem, Jerusalem 91120 (Abramson)Tufts University; Boston, MA 02111 (Rosenberg)Search for more papers by this author, and Irwin H. Rosenberg, MDHadassah Medical Organization and Hebrew University; Ein Kerem, Jerusalem 91120 (Kark)Hadassah Medical Organization and Hebrew University; Ein Kerem, Jerusalem 91120 (Abramson)Tufts University; Boston, MA 02111 (Rosenberg)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-132-9-200005020-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Eisner contends that despite the significant tests for trend in Table 3 of our paper, the data “clearly indicate a nonlinear risk pattern” on the basis of the similarity of the degree of risk elevation in the middle three quintiles of the homocysteine distribution. He expresses concern that imprecise modeling of the association has consequences for assessing causality and for public health intervention.The mortality hazard ratios (adjusting for all confounders) in successive quintiles were 1.00, 1.42, 1.28, 1.53, and 1.97 for the total study sample; we referred to the association as nonmonotonic. But reliance on these ...References1. Nygard O, Nordrehaug JE, Refsum H, Ueland PM, Farstad M, Vollset SE. Plasma homocysteine levels and mortality in patients with coronary artery disease. N Engl J Med. 1997;337:230-6. CrossrefMedlineGoogle Scholar2. Eikelboom JW, Lonn E, Genest J, Hankey G, Yusuf S. Homocyst(e)ine and cardiovascular disease: a critical review of the epidemiologic evidence. Ann Intern Med. 1999;131:363-75. LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Jeremy D. Kark, MD, PhD; Joseph H. Abramson, MB, BCh; Irwin H. Rosenberg, MDAffiliations: Hadassah Medical Organization and Hebrew University; Ein Kerem, Jerusalem 91120 (Kark)Hadassah Medical Organization and Hebrew University; Ein Kerem, Jerusalem 91120 (Abramson)Tufts University; Boston, MA 02111 (Rosenberg) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoNonfasting Plasma Total Homocysteine Level and Mortality in Middle-Aged and Elderly Men and Women in Jerusalem Jeremy D. Kark , Jacob Selhub , Bella Adler , Jaime Gofin , Joseph H. Abramson , Gideon Friedman , and Irwin H. Rosenberg Homocyst(e)ine and Cardiovascular Disease: A Critical Review of the Epidemiologic Evidence John W. Eikelboom , Eva Lonn , Jacques Genest Jr. , Graeme Hankey , and Salim Yusuf Nonfasting Plasma Total Homocysteine Level and Mortality Mark D. Eisner Metrics 2 May 2000Volume 132, Issue 9Page: 760KeywordsBlood plasmaConfidence intervalsHazard ratioMortalityPopulation attributable riskPrevention, policy, and public healthStatistical distributions ePublished: 15 August 2000 Issue Published: 2 May 2000 Copyright & PermissionsCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...