Homocysteine (Hcy), a sulfur-containing amino acid that is formed by demethylation of dietary methionine to cystein. Elevated homocysteine level is known to be associated with coronary artery disease. We present a case of acute myocardial infarction in a 25-year-old woman, associated with hyperhomocysteinaemia. Her other risk factors for coronary artery disease were smoking, a moderately high LDL level, and a family history of sudden cardiac death. This case illustrates the need to include plasma homocysteine measurement in the setting of acute coronary syndromes in women with premature atherosclerosis, even in the presence of traditional risk factors for coronary artery disease.
1. J. Selhub 1999 Homocystein metabolism Annu Rev Nutr 19 217 246.
2. M.P. Matson T.B. Shea 2003 Folate and homocystein metabolism in neural plasticity and neurodegenerative disorders Trends Neurosci 26 137 146.
3. G.V. Mann B. Andrus A. Mcnally F.J. Stare 1953 Experimental atherosclerosis in Cebus monkeys J Exp Med 98 195 218.
4. K.S. McCully 1969 Vascular pathology of homocysteinaemia: Implications for the pathogenesis of arteriosclerosis Am J Pathol 56 111 128.
5. J.H. Page J. Ma S.E. Chiuve M.J. Stampfer J. Selhub J.E. Manson E.B. Rimm 2010 Plasma total cysteine and total homocysteine and risk of myocardial infarction in women: A prospective study Am Heart J 159 599 604.
6. B. Israelsson L.E. Brattström B.L. Hultberg 1988 Homocysteine and myocardial infarction Atherosclerosis 71 227 233.
7. Homocysteine Studies Collaboration 2002 Homocysteine and risk of ischemic heart disease and stroke: a meta-analysis JAMA 288 2015 2022.
8. E. Sipahi G. Taskin D. Kumbasar M. Halloran M. Yildirimkaya F. Nadirler A. Yildirir B. Berkalp Y. Laleli 2002 Hyperhomocysteinaemia and coronary artery disease in the Turkish population Acta Cardiol 57 415 420.
9. A. Bozkurt H. Toyaksi E. Acartürk A. Tuli M. Cayli 2003 The effects of hyperhomocysteinemia on the presence, extent, and severity of coronary artery disease Jpn Heart J 44 3 357 368.
10. W.G. Christen U.A. Ajani R.J. Glynn C.H. Hennekens 2000 Blood levels of homocysteine and increased risks of cardiovascular disease Arch Intern Med 160 422 434.
11. M.K. Al-Obaidi P.J. Stubbs P. Collinson R. Conroy I. Graham M.I. Noble 2000 Elevated homocysteine levels are associated with in creased ischemic myocardial injury in acute coronary syndromes J Am Coll Cardiol 36 4 1217 1222.
12. S.R. Lentz W.G. Haynes 2004 Homocysteine: Is it a clinically important cardiovascular risk factor? Cleve Clin J Med 71 729 734.
13. M.R. Paul L. Peter 2012 Risk markers for atherothrombotic disease R.O. Bonow D.L. Mann D.P. Zipes P. Libby E. Braunwald Braunwald's heart disease. A textbook of cardiovascular medicine Elsevier Saunders Philadelphia 927.
14. J. Thambyrajah J.N. Townend 2000 Homocysteine and atherothrombosis mechanisms for injury Eur Heart J 21 967 973.
15. I.M. Graham L.E. Daly H.M. Refsum K. Robinson L.E. Brattström P.M. Ueland R.J. Palma-Reis G.H. Boers R.G. Sheahan B. Israelsson C.S. Uiterwaal R. Meleady D. McMaster P. Verhoef J. Witteman P. Rubba H. Bellet J.C. Wautrecht H.W. de Valk A.C. Sales Lúis F.M. Parrot-Rouland K.S. Tan I. Higgins D. Garcon G. Andria et al.1997 Plasma homocysteine as a risk factor for vascular disease. The European Concerted Action Project JAMA 277 1775 1781.
16. C. Maldonado C.V. Soni N.D. Todnem S. Pushpakumar D. Rosenberger S. Givvimani J. Villafane S.C. Tyagi 2010 Hyperhomocysteinemia and sudden cardiac death: Potential arrhythmogenic mechanisms Curr Vasc Pharmacol 8 64 74.
17. L. Chang B. Geng F. Yu J. Zhao H. Jiang J. Du C. Tang 2008 Hydrogen sulfide inhibits myocardial injury induced by homocysteine in rats Amino Acids 34 573 585.
18. R. Zacarías-Castillo A.E. Hernández-Rebollar A. Zajarias-Rabchinskey D. González-Bárcena 2001 Hyperhomocysteinemia. A new coronary risk factor Gac Med Mex 137 4 335 345.