Homocysteine as predictor of clinical events in patients with previous myocardial infarction

We have investigated the levels of total plasma homocysteine (tHCy) in patients having an acute myocardial infarction (AMI) and related them to clinical events after 4 years observation. The clinical events included death, reinfarction and stroke. Blood samples were drawn 3 months after AMI in 325 patients. During the observation period 55 patients suffered a predefined endpoint. In those patients the levels of tHCy were significantly elevated compared to those without (p=0.025). When comparing the risk for having an event in those being in the highest tHCy quartile (> 13.3 mumol/L) with those in the 3 lower quartiles, the OR was 2.38 (CI 1.24-4.59) (p=0.005), still significant after adjusting for age. The present results show that moderately elevated levels of plasma tHCy are related to increased risk for future clinical events in patients suffering an AMI.