Posted by Dr. Bijoykumar Barik on Thursday, 22nd July 2010AIMS AND OBJECTIVES:
Over the last few decades Coronary artery diseases (CAD) has become one of the most important causes of morbidity and mortality. Homocysteine is now emerging as an independent modifiable risk factor. Keeping this in mind the present study was undertaken at V.S.S. Medical College & Hospital, Burla in the Department of General Medicine to observe the association of hyperhomocysteinemia as a risk factor in coronary artery disease.
MATERIALS AND METHODS:
Selection of cases: any patients having evidence of CAD in the form of:
1. Myocardial infarction
2. Stable angina
3. Unstable angina.
Patients having renal diseases, hypothyroidism, SLE, Rh arthritis were excluded from this study. Patients on drugs like methotrexate, phenytoin, biguanides were also not included. 50 cases studied compared with 30 age sex match controls taken.
All the cases and controls were subjected to detail clinical examination and investigation (Routine blood tests, lipid profile, ECG, Cardiac markers) and serum homocysteine estimation by Chemiluminescence's method. A selected nos. of patients were given Vitamin supplementation (folic acid 400 microgram, B6-3mg, B12 10 microgram) for a period 6 weeks and homocysteine was re-estimated. RESULTS:
50% of patients were in the age group of 45-54 and male: female 35:15.70% of cases found to having AMI, 18% having stable angina and 12% having unstable angina. The serum Homocysteine level was found to be high in 60% of cases. (71.42% in male and 33.33 % in female). The Homocysteine level was predominantly high in younger age group. After 6 weeks of Vitamin supplementation mean homocysteine was found to be decreased to significant level (before treatment mean homocysteine level was 20.11 micro mol/L and after treatment 14.06 micromol/L.
The high Homocysteine level is associated with risk of CAD and it is more marked in younger age group and in male sex. Although results of ongoing studies of impact of vitamin-B supplementation on mortality reduction, not available, plasma homocysteine level reduction should also be consider as a prophylactic goal to reduce prevalence of CAD.