Homocysteine and lipid levels in young patients with coronary artery disease.

AIMS AND OBJECTIVES Indians are more prone to premature coronary artery disease (CAD). The importance of homocysteine as a risk factor for CAD in Indian patients needs to be recognized. The aim of this study was to note the independent association of this novel risk factor with traditional ones in young CAD patients. METHODOLOGY This study included 51 patients, < 45 years of age, with proven CAD. They were further divided into two subgroups based on their lipid profile. Group A (n = 30) hyperlipidemic CAD patients and Group B (n = 21) normolipidemic CAD patients. They were compared with 15 age and sex matched healthy controls. Plasma homocysteine was assayed using high pressure liquid chromatography, fasting lipid profile and other risk factors were compared. RESULTS The mean level of homocysteine in patient group was 27.8 +/- 13.11 nmol/ml. In subgroup A it was 28.86 +/- 13.02 while in subgroup B it was 26.46 +/- 13.44. In the patient group (n = 51), 37 (72.55%) had homocysteine levels greater than 18 nmol/ml. In the control group mean homocysteine was 13.22 nmol/ml +/- 7.36 and only 4 (26.77%) had homocysteine levels greater than the cut-off. CONCLUSIONS Thus in spite of some baseline variations, plasma homocysteine emerged as a significant (p = 0.0009, OR 6.05) independent risk factor for young CAD patients and was not altered by the baseline lipid profile of the patient. Therefore it should be evaluated in all young patients of CAD in the absence of traditional risk factors.