Praveen Singh Peter, J (2012) Hyperhomocysteinemia as a Cardiovascular risk factor in Young South Indian Population. Masters thesis, Tirunelveli Medical College, Tirunelveli.
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Abstract
INTRODUCTION: Myocardial Infarction generally occurs with the abrupt decrease in coronary blood flow that follows a thrombotic occlusion of a coronary artery previously narrowed by atherosclerosis. The injury is produced by or facilitated by factors such as cigarette smoking, hypertension, lipid accumulation, Diabetes and a number of other factors. A quote from Berkeley heart lab - "Just being an Indian descent puts you at a high risk of coronary artery disease". The pattern of coronary artery disease is indeed changing in India. It has been reported to be as follows: a) Coronary artery disease appears a decade earlier in India than other countries. b) Males are affected more than females. c) Heavy smoking is an important contributing factor. d) Hypertension and Diabetes account for about 40 percent of all cases. The above findings were based on a clinical study done in Chandigarh in Persons of age greater than 30. The risk of coronary artery disease in Indians is 3-4 times higher than white Americans, 6 times higher than Chinese and 20 times higher than Japanese Enas EA, Grag A, Davidson NA1 et al - coronary artery disease risk factors in first generation immigrant Asian Indians to the USA). AIM OF THE STUDY: The aim of the present study is 1. To estimate the plasma Homocysteine levels in young patients presenting with myocardial infarction. 2. To assess the possible role of Homocysteine as non-traditional risk factor in these patients. 3. To study the association of Homocysteine with traditional risk factors. MATERIALS AND METHODS: Setting: Department of Medicine and Department of Cardiology, Tirunelveli Medical College Hospital, Tirunelveli. Study design: This is a cross-sectional, Case control study carried out in young MI patients. Study protocol: Patients admitted in Intensive Care Unit of Tirunelveli Medical College Hospital for MI were enrolled in the study. Patients were interviewed and a designed questionnaire was used to collect demographic details, previous history of MI, presenting symptoms, the earlier medication and food supplementation used. The study protocol was duly approved by the Ethics Committee of Tirunelveli Medical College Hospital. Collaborating Department 1. Department of Medicine and Department of Cardiology, Tirunelveli Medical College Hospital, Tirunelveli. 2. Path care lab Tirunelveli. Study Criteria: Selection of patients: Inclusion Criteria: The following categories of patients from cardiology department are included in the study. 1. Inpatients admitted for myocardial infarction. 2. Patients with age 45 years and below only. Exclusion criteria: 1. Patients with age above 45 years. 2. Patients suffering from diseases such as renal failure, hypothyroidism, psoriasis, any malignancies and psychiatric disorders. 3. Patients taking drugs such as Methotrexate, oral contraceptive pills, Ldopa, nicotinic acid and Theophylline. 4. Patients taking folic acid or any vitamin supplement. CONCLUSION: At the threshold of this millennium, CAD is looming large as the new epidemic afflicting Indians at a relatively younger age. Of the 40 MI patients, 24 (60%) were having desirable plasma homocysteine levels (<15umol/L), 16(24%) were having undesirable homocysteine levels (>15umol/L). In the study, homocysteine was identified as a nontraditional risk factor for MI. Among the study population of MI significant proportion of patients were found to have higher homocysteine than control. In the study, the mean plasma homocysteine level in healthy subjects was 8.8 umol/l and in CAD patients the total plasma homocysteine was (14+7.4umol/l)(P=0.001) indicating that homocysteine level is an independent marker of CAD. It was also found that homocysteine levels were higher in patients who had additional conventional risk factors when compared to patients without such risk factors except hypercholesterolemia. However, as the study was limited to a small population due to financial constraint, analysis of a larger group would definitely give an insight into the various causative factors leading to hyperhomocysteinemia and its role in CAD among the young South Indian population. As such Asian Indians are genetically predisposed to CAD. Hence it is mandatory to determine homocysteine levels in people after thirties so that preventive measures such as vitamin supplementation and life style modifications could be undertaken and thus reduce the incidence and mortality due to CAD.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Hyperhomocysteinemia, cardiovascular, risk factor, Young South Indian Population. |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 17 Feb 2018 04:40 |
| Last Modified: | 25 Mar 2020 15:44 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/5801 |
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