To the Editor: The WENBIT study by Dr Ebbing and colleagues1 appears to refute the hypothesis of homocysteine as a cardiovascular risk factor. However, some important aspects were not considered in the article's discussion.
Homocysteine is a long-term risk factor. In the Gothenburg study,2 women with a high homocysteine level showed a higher mortality only after a follow-up of more than 15 years. Thus, short-term follow-up after cardiovascular events will probably not be able to demonstrate a benefit of B vitamins.
Lowering Homocysteine With B Vitamins in Patients With Coronary Artery Disease. JAMA. 2008;300(24):2852-2854. doi:10.1001/jama.2008.837