Elevation of plasma homocysteine levels associated with acute myocardial infarction

Senaratne, Manohara P. J.; Griffiths, Jo; Nagendran, Jayan
August 2000
Clinical & Investigative Medicine;Aug2000, Vol. 23 Issue 4, p220
Academic Journal
Objective: To study the effect of acute myocardial infarction (AMI) on plasma homocystein (Hcy) levels, to determine the optimal time to measure this risk factor for coronary artery disease. Design: A prospective case study. Setting: The Division of Cardiac Sciences, Grey Nuns Hospital in Edmonton. Patients: Sixty-two patients (40 men, 22 women) admitted to hospital with AMI. Intervention: Measurement of Hcy levels within 48 to 72 hours of admission and at 6 weeks after discharge from the Coronary Care Unit. In a second group of 15 patients, the Hcy levels were measured on hospital days 1 and 3. Main outcome measure: Comparison of the Hcy levels measured at the time of AMI and after discharge. Results: Mean (and standard error of the mean) Hcy level measured during the AMI (13.6 [0.98] Mu mol/L) was significantly higher (p < 0.05) than at 6 weeks (12.1 [1.01] Mu mol/L). Based on the 48- to 72-hour and 6-week determinations, 31 and 21 patients, respectively, had abnormal Hcy levels (greater than 12 Mu mol/L) (p < 0.001). In the separate group of 15 patients, the Hcy level measured on day 3 (9.7 [0.6] Mu mol/L) was noted to be significantly higher (p < 0.01) than on day 1 (7.7 [0.8] Mu mol/L). Conclusions: There is an elevation of Hcy during AMI that may be related to an increase in the acute-phase reactant proteins. Thus, Hcy measurement should be deferred for 6 weeks in order to determine the true baseline level.


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