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Title	Claps	Level	Year	L/Y
Interrelation of hyperhomocyst(e)inemia, factor V Leiden, and risk of future venous thromboembolism. M. Cattaneo, Maria Luisa Monzani, I. Martinelli, C. Falcon, P. Mannucci To the Editor: In their large, prospective cohort study published in the April 1, 1997 issue of Circulation ,1 Ridker et al showed that hyperhomocysteinemia is a risk factor for venous thromboembolism (VTE) only when it coexists with factor V Leid… To the Editor: In their large, prospective cohort study published in the April 1, 1997 issue of Circulation ,1 Ridker et al showed that hyperhomocysteinemia is a risk factor for venous thromboembolism (VTE) only when it coexists with factor V Leiden, which is responsible for most cases of resistance to activated protein C. Hyperhomocysteinemia alone did not increase the risk of any VTE, although it tended to increase the risk of idiopathic VTE ( P =.06). These important findings are in partial disagreement with those of previous case-control studies, which demonstrated an increased prevalence of hyperhomocysteinemia in patients with any VTE and which demonstrated that the association between hyperhomocysteinemia and any VTE was independent of the coexistence of activated protein C resistance2 or factor V Leiden.3 There are at least three possible explanations for these contrasting results: (1) Hyperhomocysteinemia is a consequence, rather than a risk … Published in Circulation	18	8	1997