Evaluation of serum homocysteine in young patients presenting with myocardial infarction: a study from rural Maharashtra

Sudam V. Khedkar, Sudeep Kumar, Praveen Patil, Anant A. Takalkar


Background: It has been shown that elevated serum homocysteine levels are associated with an increased risk of ischemic heart disease (IHD) and stroke. Also, higher homocysteine concentrations in IHD or stroke patients than in controls have been reported. Some prospective and case-control studies with inconsistent results, some with highly significant results and others with no association have been observed. Objective of the study was to evaluate the serum homocysteine level in young myocardial infarction patients of rural hospital.

Methods: The present hospital based cross sectional observational study was carried out in Department of Medicine, MIMER Medical College and Hospital, Talegaon Dabhade, Pune. The study population included 45 young patients having acute myocardial Infarction coming to our hospital. The data thus collected was entered in MS excel sheet and analysed by using SPSS 24.0 IBM USA.

Results: Mean age of the study cohort was 36.7 years with 48.9% cases in between the age of 31-40 years and 33.3% were in the age range of 41-45 years. Male predominance was seen in the study cases with 68.9% males and 31.1% females. Prevalence of hyperhmocysteinemia was observed as 64.4% in present study. Mortality rate in our study was 6.67%. Serum homocysteine and all lipid parameters were in positive correlation except High-density lipoprotein which has negative correlation. Homocysteine levels were correlating significantly with level of atherosclerosis as measured by Gensini score.

Conclusions: Coronary heart disease is related to high serum homocysteine concentration. Serum homocysteine levels also correlates well with the severity of MI.


Coronary artery disease, Homocysteine, Myocardial infarction

Full Text:



Senthil Kumar PN, Soe HH. Clinical profile of acute inferior wall myocardial infarction in a semi urban population in India. Int J Med Med Sci. 2013;4(1):17-21.

Antman, Elliott, Myocardial infarction redefined—a consensus document of the Joint European Society of Cardiology/American College of Cardiology committee for the redefinition of myocardial infarction: The Joint European Society of Cardiology/American College of Cardiology Committee. J Americ Colle Cardiol. 2000;36(3):959-69.

Egred M, Viswanathan G, Davis GK. Myocardial infarction in young adults. Postgrad Med J. 2005;81:741-5.

Harrison’s principles of internal medicine, 17th edition. United States of America: The McGraw-Hill Companies. 2007-08.

Folsom AR, Nieto FJ, McGovern PG, Tsai MY, Malinow MR, Eckfeldt JH, et al. Prospective study of coronary heart disease incidence in relation to fasting total homocysteine, related genetic polymorphisms, and B vitamins: the Atherosclerosis Risk in Communities (ARIC) study. Circulat. 1998;98(3):204-10.

Brattström L, Wilcken DE, Öhrvik J, Brudin L. Common methylenetetrahydrofolate reductase gene mutation leads to hyperhomocysteinemia but not to vascular disease: the result of a meta-analysis. Circulat. 1998;98(23):2520-6.

Poddar R, Sivasubramanian N, DiBello PM, Robinson K, Jacobsen DW. Homocysteine induces expression and secretion of monocyte chemoattractant protein-1 and interleukin-8 in human aortic endothelial cells: implications for vascular disease. Circulat. 2001;103(22):2717-23.

Majors, A, Ehrhart, LA, Pezacka, EH. Homocysteine as a risk factor for vascular disease. Enhanced collagen production and accumulation by smooth muscle cells. Arterioscler Thromb Vasc Biol. 1997;17:2074.

Starkebaum, G, Harlan, JM. Endothelial cell injury due to copper-catalyzed hydrogen peroxide generation from homocysteine. J Clin Invest. 1986;77:1370.

Fryer RH, Wilson BD, Gubler DB, Fitzgerald LA, Rodgers GM. Homocysteine, a risk factor for premature vascular disease and thrombosis, induces tissue factor activity in endothelial cells. Arteriosclerosis and Thrombosis. J Vascul Bio. 1993;13(9):1327-33.

Fuster V, Voute J. Chronic diseases are not on the agenda. Lanc. 2005;366(9496):1512–4.

Lipska K, Sylaja PN, Sarma PS, Thankappan KR, Kutty VR, Vasan RS, et al. Risk factors for acute ischaemic stroke in young adults in South India. J Neurol Neurosurg Psychiatry. 2007;78:959-63

Nayak SD, Nair M, Radhakrishnan K, Sarma PS, Ischaemic stroke in the young adult: clinical features, risk factors and outcome. Natl Med J India. 1997;10(3):107-12.

Lidegard O, Soe M, Andersen NM. Cerebral thromboembolism among young women and men from Denmark 1977 - 1982. Strok. 1986;17:670-5.

Lisovoski F, Rousseaux P. Cerebral infarction in young people: A study of 148 patients with cerebral angiography. J Neurol Neurosurg Psychiatry. 1991;54:576-7.

Ghosh K, Khare A, Shetty S. Fasting plasma homocysteine levels are increased in young patients with acute myocardial infarction from Western India. Ind Hear J. 2007;59(3):242-5.

Ramesh N, Ganesan K. A study on serum homocysteine as an independent risk factor for coronary artery disease. Int Archiv Integrat Medic. 2019;6(6):75-80.

Verhoef P, Pasman W, Vliet T, Urgert R, Katan M. Contribution of caffeine to the homocysteine-raising effect of coffee: a randomized controlled trial in humans. Am J Clin Nutr. 2002;76(6):1244–8.

Shanoli G, Sanchita R, Soumitra K, Pritha P, Atreyee D, Ajanta H. Homocysteine-Is there any role in Coronary Heart Disease? J Cardiovascul Dise Resea. 2017;8(2).

Chauhan A, Tailor P, Joshi R. Evaluationof serum homocysteine as an independent risk factor formyocardial infarction in young patients. Nat J Med Res. 2012;2(4):423-6.

Patil SS, Joshi R, Gupta G, Reddy MV, Pai M, Kalantri SP. Risk factors for acute myocardial infarction in a rural population of central India: a hospitalbased case control study. Natl Med J India, 2004;17:189–94

Schaffer A, Verdoia M, Cassetti E, Marino P, Suryapranata H, Luca GD. Relationship between homocysteine and coronary artery disease. Results from a large perspective cohort study. Thromb Res. 2014;134:288–93.