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Serum homocysteine level as a predictive marker in patients of coronary artery disease – A study of 150 cases

Mrunal Naiksatam, Vijay C Popat, Alpeshkumar D Chavda.




Abstract
Cited by 2 Articles

Background: Coronary Artery Disease (CAD) has a high prevalence in Asian Indians. The Acute Myocardial Infarction (AMI) or Ischemic Heart Disease is rapidly increasing in India and in the developing countries. India is on an epidemiological threshold of experiencing significant increase in cardiovascular diseases. This predilection to Coronary Heart Disease is attributable to a clustering of various risk factors. The factors implicated include: The lifestyle modifiable risk factors such as smoking, obesity, physical inactivity and those modifiable by lifestyle as well as pharmacotherapy such as lipid disorder, hypertension, and insulin resistance. The non-modifiable risk factors include age, sex and genetics. These are reasonably well established. The high rate of coronary heart disease however cannot be explained by the presence of these conventional risk factors alone. Of all the ethnic groups, people of Indian origin have one of the highest incidences of CAD.

Aim and Objective: To study and establish correlation of Hyperhomocysteinemia with various coronary risk factors such as Age, Sex, socioeconomic status, and other lifestyle factors such as occupation, smoking, alcohol, tea/coffee, Dyslipidemia, hypertension, obesity and diabetes.

Materials and Methods: The study was conducted in the department of Pathology at M.P. Shah Government medical college and Guru Gobind Singh hospital, Jamnagar- Gujarat; it was undertaken over a period of two years from August-2018 to August-2020. A total of 150 patients receiving In-patient care in the hospital were selected to enter the study. This was a cross-sectional study. Detailed clinical history and other important parameters as well as findings of all the concerned patients were collected. Estimation of serum homocysteine level done of all 150 patients.

Results: This study was conducted in 150 patients admitted at a tertiary care center in Saurashtra region, for a duration of two years from August 2018-August 2020. The study was a cross-sectional study and included 150 patients who were diagnosed cases of coronary artery disease or Ischemic Heart Disease or previous history of Cardiac arrest. This study showed a male preponderance of coronary artery disease. Hyperhomocysteinemia is found to be an important risk factor in patients with younger age presenting with CAD.

Conclusion: In this study, we showed that elevated level of homocysteine is significantly associated with CAD risk independent of other risk factors. Positive correlation was established between hyperhomocysteinemia and major traditional risk factors of Coronary artery disease mainly - Dyslipidemia, diabetes, hypertension and obesity and were proved statistically significant.

Key words: Serum Homocysteine; Predictive Marker; Coronary Artery Disease






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