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During the last years, a growing body of evidence has been accumulated on the role of hyperhomocystein-emia in the occurrence of coronary artery disease and other arterial occlusive diseases. The mechanism by which high circulating homocysteine concentrations are a risk factor for atherothrombosis is incompletely understood. The present review is aimed to evaluate the role of inflammation in influencing homocysteine (Hcy) and vitamin B6 concentrations. Results of a large population-based study have suggested that inflammatory markers are the major determinants of Hcy and vitamin B6 concentrations. This association, independent of the leading factor, may explain, at least in part, why subjects with high concentrations of Hcy and low concentrations of vitamin B6 have a high risk of developing cardiovascular diseases.