The prevalence of hyperhomocysteinemia and its correlation with conven- tional risk factors in young patients with myocardial infarction in a terti- ary care centre of India

Coronary artery disease (CAD) has become the most common cause of mortality in the entire world. Indians are more prone to premature coronary artery disease. About 20% patients with CAD have no identifiable risk factors. Thus the importance of homocysteine as a risk factor for CAD in Indian patients needs to be recognized. The aim of this study was to assess the homocysteine levels in young patients with myocardial infarction (MI) and to compare them with conventional risk factors. The study was conducted in 30 male patients of acute myocardial infarction admitted in Coronary Care Unit. All were younger than 45 yrs with no history of previous CAD. Plasma homocysteine was assayed using photometry. Fasting lipid profile and other risk factors were compared. In the present study the mean age of the patients was 39.5 ± 2.8 years. The prevalence of hyperhomocysteinemia was 83.3%. The mean homocysteine was more in smokers than in nonsmokers (32.1 ± 3.5 vs 24.3 ± 5.7, p< 0.001). Homocysteine level had significant negative correlation with serum HDL level (Pearson’s coefficient -0.437; p value =0.016). No association of hyperhomocysteinemia with other conventional risk factors was found. Plasma homocysteine has emerged as a significant independent risk factor for young MI patients. Therefore, plasma homocysteine should be evaluated in all young patients with myocardial infarction especially in the absence of traditional risk factors.