Increase in the risk of ST elevation myocardial infarction is associated with homocysteine level

Area of Science:

• Cardiology
• Clinical Biochemistry
• Genetics

Background:

• ST-elevation myocardial infarction (STEMI) in low-risk individuals without known coronary artery disease risk factors presents a diagnostic challenge.
• Investigating coagulation defects and biochemical markers is crucial for understanding STEMI etiology in these atypical cases.

Purpose of the Study:

• To examine the relationship between specific coagulation defects and STEMI in patients categorized as low risk by the Framingham risk score.
• To identify potential independent risk factors for STEMI in individuals lacking conventional risk indicators.

Main Methods:

• A case-control study involving 76 STEMI patients without known coronary artery disease risk factors and 56 healthy controls.
• Assessed levels of coagulation factors (Protein C, S, Antithrombin 3), specific mutations (Factor V Leiden), antiphospholipid syndrome, and plasma homocysteine, vitamin B12, and folate.

Main Results:

• No significant differences were found in Protein C, S, or Antithrombin 3 levels between STEMI patients and controls.
• Plasma homocysteine levels were significantly higher in STEMI patients (19.0 ± 3.6 μmol/L) compared to controls (15.8 ± 4.2 μmol/L), p=0.008.
• Factor V Leiden mutation was present in two patients and one control; no participants had antiphospholipid syndrome or deficiencies in Factor V or VII.

Conclusions:

• Elevated plasma homocysteine levels are associated with STEMI in patients without traditional risk factors.
• These findings suggest that homocysteine may serve as an independent risk factor for coronary artery disease, even in low-risk populations.