A study on serum homocysteine as an independent risk factor for coronary artery disease.

Background: Coronary artery disease (CAD) has become the most common cause of mortality in the entire world. Homocysteine is implicated as an early atherosclerotic promoter. Homocysteine (Hcy) is an essential amino acid in humans. It has been known as a novel and independent risk factor for coronary heart disease (CHD). The prevalence of hyperhomocysteinemia varies between 5% and 30% in the general population. Aim of the study: To assess whether hyperhomocysteinemia is one of the independent risk factors for coronary artery disease. Materials and methods: The study was conducted in the Department of General Medicine, Government K.A.P. Viswanatham Medical College, Trichy from 2017-2018. Totally 100 Patients who were presented to our hospital with coronary artery disease of age group 30 to 70 years were included in the study. Diagnosis of coronary artery disease was made based on a history of angina pain, electrocardiography (ECG) changes and cardiac enzyme levels. Diagnosis of acute MI was made according to WHO criteria. Results: Among the 100 patients, 66 had acute Myocardial Infarction and 34 had angina. Among the 52 patients who had hyperhomocysteinemia, 34 patients (65%) were young with age = 45 years and 18 patients (35%) were with age> 45 years. In our study, 66 patients with MI were included. Among the 28 patients (42.4%) were young with age <45 years. In this group of young patients with MI, 21 patients (65.4%) had hyperhomocysteinemia and 7 patients (34.6%) had normal homocysteine level. Conclusion: Finally, during the last decade, the utility of homocysteine in predicting risk for atherothrombotic vascular disease has been evaluated in several observational studies in a large number of patients. These studies show that the overall risk for vascular disease is small, with prospective, longitudinal studies reporting a weaker association between homocysteine and atherothrombotic vascular disease compared to retrospective case-control and cross-sectional studies. Furthermore, randomized controlled trials of homocysteine-lowering therapy have failed to prove a causal relationship. [ABSTRACT FROM AUTHOR]