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An elevated plasma level of total homocysteine (tHcy) has long been known as an independent predictor of cardiovascular disease (CVD). However, in the absence of a clear mechanism linking tHcy to CVD, there has been an ongoing debate whether this relationship is one of cause and effect or whether an elevated level of plasma tHcy is an epiphenomenon. The aim of the present study was to evaluate possible correlations between high levels of tHcy and the anti-inflammatory agent HDL-C along with the atherogenic LDL-C and TGs in adult patients with acute cardiovascular events. Method and Materials: tHcy, TGs, HDL-C and LDL-C levels were measured in 94 patients (51 men, 43 women) 48-66 y aged, who were admitted to ICU of Cardiology Department. tHcy levels were measured using fluorescence polarization immunoassay (FPIA). Results: Mean serum tHcy was found 16.63±7.55 μmol/l. There was no significant correlation between tHcy and TGs and LDL-C levels. On the contrary, a negative relationship between tHcy and HDL-C concentration was found with Pearson’s correlation coefficient (r = – 0.42). Conclusions: In this study, we detected and evaluated a negative relationship between t-Hcy and HDL-C levels in a hospitalized ICU population from the Greater Metropolitan area of Athens.