Several studies showed that hyperhomocysteinemia is associated with an increased risk of atherosclerotic vascular disease. Our aim was To investigate: the use of systematic detection of hyperhomocysteinemia in a coronary population, to cite several treatment recommendations which were indicated by other clinical trials of homocysteine lowering for cardiovascular outcome prevention. We measured plasmatic homocysteine concentration in 100 coronary patients (56.50 +/- 11.80 years old) and 40 healthy subjects (57.45 +/- 8.66 years old). Homocysteine concentration was significantly increased in coronary patients compared to control subjects (19.79 +/- 7.95 imol/l vs 13.08 +/- 2.66 imol/l). Hyperhomocysteine prevalence was 72% among our coronary patients who showed mostly moderate acute myocardial infarction (AMI). Patients with posterior AMI showed significant higher homocysteine concentration than inferior AMI. This study allowed us to estimate homocysteine prevalence and to appreciate the usefulness of a homocysteine systematic measure in coronary patients.