Relationship between Serum Homocysteine Levels among Young Patients with Acute Myocardial Infarction

Abstract

Background: Acute Myocardial Infarction (AMI) is a leading cause of morbidity and mortality, particularly in young adults. Homocysteine, an emerging biomarker, has been implicated in cardiovascular risk, yet its role in young AMI patients remains underexplored. Objective: This study aimed to evaluate the relationship between serum homocysteine levels among young patients with acute myocardial infarction. Methods: A longitudinal descriptive study was conducted from July 2021 to June 2022 among 64 patients presenting with a first episode of acute myocardial infarction (AMI) at a tertiary-care hospital. The study took place in the Department of Medicine in collaboration with the Department of Cardiology, RMCH. Using purposive sampling, detailed demographic and clinical data were obtained from all participants, through a semi-structured questionnaire. Blood samples were taken within 12 hours of admission to measure serum homocysteine and troponin I, alongside lipid profiles, creatinine, electrolytes, vitamin B12, and folate. In-hospital complications were monitored until discharge or the end of hospitalization. Statistical analyses using SPSS 25.0 examined the associations between homocysteine levels, comorbidities, complications, and myocardial injury. Results: The mean age of respondents was 33.17±5.17 years, with 75% being male and 64.1% residing in rural areas. Hypertension (78.1%) and dyslipidemia (57.8%) were the most prevalent comorbidities. Elevated homocysteine levels were significantly associated with dyslipidemia (p<0.001) and higher troponin I levels (r=0.803, p<0.001). In-hospital complications occurred in 52.2% of patients with elevated homocysteine levels, while no complications were observed in those with normal levels (p<0.001). Conclusion: Elevated homocysteine strongly correlates with dyslipidemia, myocardial injury, and increased in-hospital complications in young AMI. Routine screening may improve risk assessment and outcomes, warranting further exploration.