Elevation of plasma homocysteine levels associated with acute myocardial infarction
Senaratne, M.P.; Griffiths, J.; Nagendran, J.
Clinical and Investigative Medicine 23(4): 220-226
2000
ISSN/ISBN: 0147-958X PMID: 10981532 Document Number: 520477
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) mumol/L) was significantly higher (p < 0.05) than at 6 weeks (12.1 (1.01) mumol/L). Based on the 48- to 72-hour and 6-week determinations, 31 and 21 patients, respectively, had abnormal Hcy levels (greater than 12 mumol/L) (p < 0.001). In the separate group of 15 patients, the Hcy level measured on day 3 (9.7 (0.6) mumol/L) was noted to be significantly higher (p < 0.01) than on day 1 (7.7 (0.8) mumol/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.