Serum homocysteine level as a predictive marker in patients of coronary artery disease - A study of 150 cases

The study was a cross-sectional study and included 150 patients who were diagnosed cases of coronary artery disease or Ischemic Heart Disease or previous history of Cardiac arrest. Epidemiological studies have convincingly shown that up to 90% of all CVD can be explained by a small number of modifiable risk factors, including blood pressure, smoking, diabetes, total cholesterol and excess body weight. Inclusion Criteria * All patients admitted at G.G Hospital having history of coronary artery disease or any previous history of cardiac arrest. * Patients on medications or previous treatment history for Angina/Myocardial Infarction or any other cardiac ailment. Assay Principle * The Weldon homocysteine 2 Reagent Enzymatic assay was used which can aid and assist in the diagnosis and treatment of patients suspected of having hyperhomocysteinemia and homocystinuria. * It is based on a novel assay principle that assesses the co-substrate conversion product (a molecule that is not a substrate of the Hcy conversion enzyme, and does not contain any element from sample Hcy) instead of assessing co-substrate or Hcy conversion products individually. * In this assay, oxidized Hcy is first reduced to free Hcy which then reacts with a co-substrate, S-adenosylmethionine (SAM) catalyzed by a Hcy S-methyltransferase to form methionine and S-adenosylhomocysteine. * SAH is assessed by coupled enzyme reactions including SAH Hydrolase, adenosine deaminase and glutamate dehydrogenase, wherein SAH is hydrolysed into adenosine and Hcy by SAH hydrolase. * The formed adenosine is immediately hydrolysed into inosine and ammonia which reacts with glutamate dehydrogenase with concomitant conversions of NADH to NAD+.