European Journal of Molecular & Clinical Medicine

Homocysteine occupies a branch point in methionine, cysteine and S-adenosylmethionine (SAM) metabolism. About half of the homocysteine formed is conserved by remethylation to methionine in the “methionine cycle”. The other half is irreversibly converted by cystathionine-β-synthase (CBS) and cystathionine 𝛾-lyase to cysteine. After getting the informed consents from the subjects, 2.5ml of fasting blood samples were collected for lipid profile in a plain vacutainer tube and 2.5 ml of blood sample were collected in EDTA tubes for homocysteine estimation. This however, was done after the 7th day of the last menstrual period for premenopausal group. Samples were centrifuged at 3000 rpm to separate serum and plasma for the analysis of lipid profile and homocysteine estimation. The positive correlation between BMI and homocysteine which clearly indicates the increase in BMI results in increase in plasma homocysteine levels with Pearson correlation co-efficient of 0.232 and p value of 0.11.

Background: Evidence from retrospective and prospective clinical studies indicates that
elevated levels of homocysteine are associated with increased risk of CAD, Ischemic stroke
and peripheral vascular disease. Present study was aimed to study role of Homocysteine as a
risk factor in patients with Acute Vascular Events.
Material and Methods: Present study was prospective, observational study, conducted in
patients with age above 18 years, either gender, admitted for Ischemic heart disease,
peripheral vascular disease, Deep Vein Thrombosis and Pulmonary Thromboembolism.
Results: In this study most of the cases are between the age group of 60-69 years (55%).
Youngest patient in this study is 20 year old. This is a male dominated study with males
comprising 72% of the study group. In this study Dyslipidemia (62%) is the most common
risk factor followed by Smoking (53%). Hypertension (50%) and Diabetes mellitus (41%) are
observed. Family h/o CAD (20%) is present and only (14%) patient was alcoholic.
Overweight is present among 41% of patients. In this study significant number of patients
(72%) have hyperhomocysteinemia. 47% of patients are moderate and 23% are intermediate.
Only 2 patients have severe hyperhomocysteinemia. Mean plasma homocysteine level is
11±3μmol/L and is statistically significant. The mean plasma homocysteine was high among
smokers when compared to non-smokers difference was highly significant. No much
significant difference was noted in mean values of homocysteine among patients with other
high risk factors, such as alcohol consumption, diabetic, dyslipidemia, BMI, family history of
CAD. Hyperhomocysteinemia is seen in 38 out of 51 patients with Cerebrovascular Disease,
32 out of 42 patients with Cardiovascular Disease, one of 4 patients with Peripheral arterial
Disease and one with Deep vein thrombosis.
Conclusion: Plasma homocysteine should be considered as an independent risk factor for the
development of future acute vascular event.