Muhammad Naeem Aslam, Fayyaz A Malik, Humera Jawad, Ejaz Anwar, Javid Aziz Awan, Yousaf Hassan Khan, Iqbal M.
Relation of smoking and elevated Homocysteine in patients presenting with acute coronary syndrome.
Pak J Cardiol Jan ;17(2-3):48-56.

BackGround: Elevated plasma homocysteine levels. homocysteine levels are risk factor for coronary artery disease. Smoking is known to be Other risk factors like diabetes mellitus, associated with an increased plasmafamily history, obesity and dyslipidemia were homocysteine level and both with increased riskalso studied. of cardiovascular disease. Objective: To investigate the relation ship between smoking, plasma homocysteine and other conventional risk factors with coronary artery disease in relatively younger population of patients presenting with acute coronary syndrome in emergency room of Cardiology Department, Allied Hospital Faisalabad. Results: Among 586 patients of ACS under 50 years, 221(38%) patients were found to be smokers. Smoking habit showed significant difference between male and female patients as 177 (80 %) male and 44 (20%) female. Homocysteine level of 22.4% patients among all was high and was found associated (63.5% of smokers) with smoking habit Methods: Out of 1852 consecutive patients(P<0.01). Hypertension was not among admitted in emergency room of Cardiologysignificant factors for smokers as 421 (65%) Department, Allied Hospital Faisalabad overwere not suffering from hypertension. There one year, 1375 (74%) presented with acute chestwere 93 obese among smokers and these two pain, 586 were under 50 year. 384 (66%) wererisk factors collectively posed insignificant males 202 (34 %). 200 (34 %) were under 40effect (P<0.05). years. 386 (66%) patients were in age range 41 - 50 years. The demographic details, history and clinical examination of patients were recorded and their blood was collected in fasting state for estimation of serum total cholesterol, plasma glucose and serum total Conclusion: It was concluded that smokers were more prone to have coronary heart disease due to increased levels of homocysteine, its association with abnormal lipid profile and especially when some other risk factor combines with smoking greatly increases the risk of cardiovascular disease and should therefore be offered intensive advice to help them cease smoking also have reduced levels of homocysteine .

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