Why the study?
Elevated serum homocysteine is an important risk factor for coronary artery disease, highlighting the need to evaluate its role in young patients presenting without conventional risk factors.
This case illustrates the need to evaluate plasma homocysteine levels in young patients presenting with coronary artery disease without conventional risk factors.
Elevated homocysteine may signal premature MI risk in young adults; leaves open whether screening or treatment improves outcomes.
Homocysteine is sulfur containing intermediary amino acid formed by the demethylation of dietary methionine to cysteine. The raised serum homocysteine level is one of the important risk factors associated with coronary artery disease. We present a 23-year-old male with no other risk factors of coronary artery disease presented to us with acute anterior wall myocardial infarction and was treated with primary percutaneous coronary intervention. During the routine work up post percutaneous coronary intervention significant elevation of serum homocysteine level was seen with markedly low serum vitamin B12 level and was treated for it along with standard therapy for acute myocardial infarction. The case illustrates the need to incorporate a plasma homocysteine level during work up of coronary artery disease especially in young patients, more importantly in those without any conventional risk factors.
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Acharya et al. (2020) studied this question.
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