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Abstract

Background:Coronary Artery Disease (CAD) is growingly common and usually linked to non-traditional risk factors. Hyperhomocysteinemia is a modifiable biochemical aberration which is associated with endothelial dysfunction, inflammation, and thrombosis which all contribute to atherosclerosis. Its contribution to early CAD needs dedicated Study in the younger age groups.
Objectives: To estimate the prevalence of hyperhomocysteinemia in patients younger than 45 years of age with angiographic ally documented CAD and also to identify the relationship between hyperhomocysteinemia and the severity of the disease independent of conventional risk factors.
Study design: A cross-sectional study.
Place and duration of study. Department of Cardiology Bolan Medical Complex Hospital Quetta/ Sandeman Provincial Hospital, Quetta From 01 October 2024 to 31 March 2025
Methods: This cross-sectional study was Conducted in Cardiology Department Bolan Medical Complex Hospital Quetta/ Sandeman Provincial Hospital, Quetta from 01 October 2024 to 31 March 2025. One hundred patients age < 45 years with angiographic ally proven CAD were recruited. The level of serum homocysteine was measured by enzymatic immunoassay. The extent of CAD was defined according to the involved vessels. Data on age, gender, lipid profile, smoking, hypertension, and diabetes were collected. Statistical analysis was performed using the SPSS v24.0.
Results: Of the 100 patients, 70 (35%) patients were found to have hyperhomocysteinemia ( >= 15 moll/L). The mean age was 30.4 4.1 years. The high homocysteine patients contained more triple-vessel disease (p = 0.003). No significant difference in smoking, diabetes or lipid levels was present. The severity of CAD was independently associated with increased homocysteine level. Homocysteine levels were strongly correlated with the number of vessels involved (r = 0.42, p < 0.01).
Conclusion: Hyperhomocysteinemia is an easily determined and potentially modifiable risk factor in younger patients with coronary artery disease. Its close association with disease severity suggests that frequent screening in younger patients with known or potential CAD risk factors could play a significant role in detection and intervention to reduce the impact of early atherosclerosis and improve long-term cardiovascular outcomes in this age group.