• Nimrah Siddique CMH Institute of Medical Sciences, Bahawalpur, Pakistan
Keywords: AMI, MI, CAD, Folic acid, Hcy, Acute Myocardial Infarction, Myocardial Infarction, Coronary Artery Disease, Homocysteine


Background: Acute Myocardial Infarction (AMI) is a leading cause of mortality worldwide. An emerging risk factor for AMI is raised levels of Homocysteine (Hcy). Deficient levels of folic acid are associated with Hyperhomocysteinemia (HHcy).ortification of folic acid has been known to improve endothelial dysfunction. We aimed to determine the levels of Hcy and folic acid in patients with AMI and healthy individuals. Methods: This cross-sectional comparative study was conducted on 80 subjects, with 40 subjects in each group. Group A included individuals diagnosed with AMI and group B included healthy individuals. Serum Hcy and folic acid levels were measured by Enzyme Linked Immunosorbent Assay (ELISA). Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) were measured, and Body Mass Index (BMI) was calculated. Results: Increased Hcy and lower serum folic acid levels were found in group A as compared to group B (p<0.001). The correlation between serum Hcy level and folic acid in group A was moderate and negative (r= -0.48, p=0.001); for group B it was also moderate and more negative (r= -0.66, p<0.001). Conclusions: There were high levels of Hcy and low levels of folic acid in diseased group as compared to healthy participants.


Rizzacasa B, Morini E, Mango R, Vancheri C, Budassi S, Massaro G, et al. MiR-423 is differentially expressed in patients with stable and unstable coronary artery disease: A pilot study. PLoS One. 2019;14(5):6363.

Ioacara S, Popescu AC, Tenenbaum J, Dimulescu DR, Popescu MR, Sirbu A, et al. Acute Myocardial Infarction Mortality Rates and Trends in Romania between 1994 and 2017. International Journal of Environmental Research and Public Health. 2020;17(1):285.

Wang P, Huang Y. Clinical characteristics and influencing factors of pre-hospital delay of the second acute myocardial infarction. International Journal of Early Childhood Special Education (INT-JECSE). 2020;29(5):1407.

Khoury S, Soleman M, Margolis G, Barashi R, Rozenbaum Z, Keren G, et al. Incidence, characteristics and outcomes in very young patients with ST segment elevation myocardial infarction. Coronary artery disease. 2019;31(2):103-8.

Bates ER. In patients with suspected AMI and LBBB, algorithms based on ECG and troponin data were tested to rule MI in or out. Annals of internal medicine. 2019;171(8):JC47.

Bahall M, Seemungal T, Legall G. Risk factors for first-time acute myocardial infarction patients in Trinidad. BMC public health. 2018;18(1):161.

Pertiwi D, Yaswir R, editors. Correlation of Homocysteine Levels With Folate Acid, Cyanocobalamine, and Pyridoxine Serum Levels In Acute Infark Miocard Patients. IOP Conference Series: Earth and Environmental Science; 2019: IOP Publishing.

Hasan T, Arora R, Bansal AK, Bhattacharya R, Sharma GS, Singh LR. Disturbed homocysteine metabolism is associated with cancer. Experimental & molecular medicine. 2019;51(2):1-13.

Cohen E, Margalit I, Shochat T, Goldberg E, Krause I. The relationship between the concentration of plasma homocysteine and chronic kidney disease: a cross sectional study of a large cohort. Journal of nephrology. 2019;32(5):783-9.

Afrose L, Qamar J. Current Trends of Cardiovascular Risk Determinants in Pakistan. Cureus. 2018;10(10).

Esnafoğlu E, Yaman E. Vitamin B12, folic acid, homocysteine and vitamin D levels in children and adolescents with obsessive compulsive disorder. Psychiatry Research. 2017;254:232-7.

Zhang S, Bai Y-Y, Luo L-M, Xiao W-K, Wu H-M, Ye P. Association between serum homocysteine and arterial stiffness in elderly: a community-based study. Journal of geriatric cardiology: JGC. 2014;11(1):32.

Zarich S, Luciano C, Hulford J, Abdullah A. Prevalence of metabolic syndrome in young patients with acute MI: does the Framingham Risk Score underestimate cardiovascular risk in this population? Diabetes Vasc Dis Res. 2006;3(2):103-7.

Schaffer A, Verdoia M, Cassetti E, Marino P, Suryapranata H, De Luca G, et al. Relationship between homocysteine and coronary artery disease. Results from a large prospective cohort study. Thrombosis research. 2014;134(2):288-93.

Fedeli U, Cestari L, Ferroni E, Avossa F, Saugo M, Modesti PA. Ethnic inequalities in acute myocardial infarction hospitalization rates among young and middle-aged adults in Northern Italy: high risk for South Asians. Internal and emergency medicine. 2018;13(2):177-82.

Jafary MH, Samad A, Ishaq M, Jawaid SA, Ahmad M, Vohra EA. Profile of acute myocardial infarction (AMI) in Pakistan. Pakistan Journal of Medical Sciences. 2007;23(4):485.

Javed I, Iqbal MJ, Arshad S, Javed MT, Masood Z. A study on Acute Myocardial Infarction with special reference to age, sex, type of infarct and associated risk factors. Pakistan Journal of Medical Sciences. 2012;28(1):143-8.

Zhu W, Cai J, Hu Y, Zhang H, Han X, Zheng H, et al. Long-term exposure to fine particulate matter relates with incident myocardial infarction (MI) risks and post-MI mortality: A meta-analysis. Chemosphere. 2020:128903.

Liaquat A, Javed Q. Current Trends of Cardiovascular Risk Determinants in Pakistan. Cureus. 2018;10(10).

Mahajan AM, Gandhi H, Smilowitz NR, Roe MT, Hellkamp AS, Chiswell K, et al. Seasonal and circadian patterns of myocardial infarction by coronary artery disease status and sex in the ACTION Registry-GWTG. International journal of cardiology. 2019;274:16-20.

Alsawas M, Wang Z, Murad MH, Yousufuddin M. Gender disparities among hospitalised patients with acute myocardial infarction, acute decompensated heart failure or pneumonia: retrospective cohort study. BMJ open. 2019;9(1):227-82.

Mehta LS, Beckie TM, DeVon HA, Grines CL, Krumholz HM, Johnson MN, et al. Acute myocardial infarction in women: a scientific statement from the American Heart Association. Circulation. 2016:CIR.351.

Gómez-Donoso C, Martínez-González MÁ, Martínez JA, Gea A, Sanz-Serrano J, Perez-Cueto FJ, et al. A provegetarian food pattern emphasizing preference for healthy plant-derived foods reduces the risk of overweight/obesity in the SUN cohort. Nutrients. 2019;11(7):1553.

Garcia G, Trejos J, Restrepo B, Landázuri P. Homocysteine, folate and vitamin B12 in Colombian patients with coronary disease. Arquivos brasileiros de cardiologia. 2007;89(2):79-85.

Adam AM, Rehan A, Waseem N, Iqbal U, Saleem H, Ali MA, et al. Prevalence of conventional risk factors and evaluation of baseline indices among young and elderly patients with coronary artery disease. Journal of clinical and diagnostic research: JCDR. 2017;11(7):OC34.

Siadat M, Kazemi T, Hajihosseni M. Cardiovascular Risk-Factors in the Eastern Iranian Population: Are We Approaching 25× 25 Target? Journal of research in health sciences. 2016;16(1):51-2.

Deb R, Arora J, Samtani R, Garg G, Saksena D, Sharma N, et al. Folic acid, dietary habits, and homocysteine levels in relation to neural tube defects: A case–control study in North India. Birth Defects Research. 2018;110(14):1148-52.

Ma Y, Peng D, Liu C, Huang C, Luo J. Serum high concentrations of homocysteine and low levels of folic acid and vitamin B 12 are significantly correlated with the categories of coronary artery diseases. BMC cardiovascular disorders. 2017;17(1):37.

Baszczuk A, Thielemann A, Musialik K, Kopczynski J, Bielawska L, Dzumak A, et al. The impact of supplementation with folic acid on homocysteine concentration and selected lipoprotein parameters in patients with primary hypertension. Journal of nutritional science and vitaminology. 2017;63(2):96-103.

Akyürek Ö, Akbal E, Güneş F. Increase in the risk of ST elevation myocardial infarction is associated with homocysteine level. Archives of medical research. 2014;45(6):501-6.


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Siddique N, Siddique M, Gohier A, Karim A. COMPARISON OF SERUM HOMOCYSTEINE AND FOLIC ACID LEVELS IN ACUTE MYOCARDIAL INFARCTION AND NORMAL HEALTHY POPULATION. PJP [Internet]. 30Sep.2021 [cited 18Jan.2022];17(3):7-0. Available from: