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Homocysteine and hemostatic disorder as a risk factor for myocardial infarction at a young age

Masakazu Ogawa1, Satoshi Abe, Masahiko Saigo

  • 1First Department of Internal Medicine, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, 890-8520, Kagoshima, Japan.

Thrombosis Research
|June 24, 2003
PubMed

Insights

High homocysteine levels (hyperhomocysteinemia) are a significant risk factor for early myocardial infarction. This condition is linked to a hypercoagulable state, increasing the risk of heart attacks in younger men.

Area of Science:

  • Cardiovascular Medicine
  • Hematology
  • Biochemistry

Background:

  • Hyperhomocysteinemia is recognized as a risk factor for coronary artery disease, but its precise role in the development of myocardial infarction is not fully understood.
  • The study investigates the association between elevated homocysteine levels and early-onset myocardial infarction.

Purpose of the Study:

  • To determine the significance of hyperhomocysteinemia in the pathogenesis of myocardial infarction occurring at a young age.
  • To explore the relationship between hyperhomocysteinemia and various hemostatic factors.

Main Methods:

  • A case-control study was conducted involving 127 men with first myocardial infarction at age 45 or younger and 150 age-matched male controls.
  • Plasma levels of homocysteine and a panel of coagulation and fibrinolytic factors were measured, including tissue factor, antithrombin, and lipoprotein(a).

Main Results:

  • Patients with early myocardial infarction exhibited significantly higher plasma homocysteine concentrations compared to controls (P<0.001).
  • Hyperhomocysteinemia was independently associated with early myocardial infarction (odds ratio=2.22, P<0.001), identified as the strongest predictor in logistic regression analysis.
  • Elevated homocysteine levels correlated positively with tissue factor, tissue factor pathway inhibitor, and tissue plasminogen activator in patients.

Conclusions:

  • Hyperhomocysteinemia is confirmed as an independent risk factor for early myocardial infarction.
  • The findings suggest that hyperhomocysteinemia contributes to a hypercoagulable state, potentially mediated by the extrinsic coagulation pathway, increasing the risk of premature heart attacks.
Abstract

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