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Evaluation of homocysteine, vitamin B12 and folic acid in young patients with myocardial infarction

Ashuma Sachdeva, Veena Singh, Himanshu Madaan, Kiran Dahiya

In the developing worlds of today, ischemic heart disease (IHD) is responsible for causing more deaths and disability than any other illness and it has been predicted that IHD is likely to be the major cause of death worldwide by the year 2020, surpassing diseases like cancer. Homocysteine (Hcy), a non proteinogenic amino acid is being increasingly recognized as an independent risk factor in the etiology of vascular diseases. Normal Hcy levels in body (3.7-13.9 umol/l) are maintained by adequate supply of vitamin B12 and folic acid which aid in metabolism of Hcy. This prospective study was conducted to compare the levels of homocysteine, vitamin B12 and folic acid (estimated by Chemiluminescence) in 45 young (30-55years) cardiac patients (who had sufferedmyocardial infarction) with 40 agematched normal controls. The mean serum homocysteine in the patients with MI was 21.72 µmol/l and 8.34 µmol/l in controls. Vitamin B12 deficiencywas seen in 25/45 cases and 18/40 controls.However serumfolate levelwas normal in all the subjects. This study shows a positive correlation between hyperhomocysteinemia and acute coronary syndrome. This was also associated with vitamin B12 defeciency particularly in vegetarians.So vitamin supplementation could be of help in such cases.