ABSTRACT
A number of risk factors are known to predispose to coronary artery disease. Some of these for example age; sex and family history can not be modified, whereas others can be changed. These associations include dyslipidemia, hypertension, tobacco use and diabetes mellitus. Other risk factors include physical inactivity, obesity, family history of CAD, age, gender, hemostatic factor, homocysteine, alcohol consumption and psychosocial factors. Hyperhomocysteinemia is an emerging risk factor, independently associated with an increased risk of coronary artery disease, cerebral vascular disease and peripheral vascular disease. To compare scrum TC, TG, HDL-C, LDL-Q and total homocycteine levels in patients with documented acute myocardial infarction with the serum levels of controls without established myocardial infarction. Thirty one patients < 60 years of age fulfilling the WHO criteria for acute myocardial infarction were selected from NICVD Karachi and were matched with thirty one controls having a normal ECG and no history of IHD. Patients suffering from acute myocardial infarction had a mean total homocysteine level 14.97 +/- 1.13 while in the control the mean total homocysteine level is 10.57 +/- 0.31 [p<0.001], other lipid parameters i.e. TC, TG, HDL-C and LDL-C are significantly different in patients with acute myocardial infarction as compared to controls. Although the serum total cholesterol level [192.85 +/- 10.84] is higher in patients with acute myocardial infarction as compared to controls [166.14 +/- 11.89], but is not significant statistically. The patients with acute myocardial infarction have higher levels of scrum total homocysteine than control subjects suggesting that this variable may strongly predispose to CAD in our country