The Relationship Between Serum Homocysteine Levels and the Severity of Acute Myocardial Infarction Associated with a Gensini Score

Oct 13, 2025 by wbrum.org 114 views

The Relationship Between Serum Homocysteine Levels and the Severity of Acute Myocardial Infarction Associated with a Gensini Score

Introduction

Coronary heart disease (CHD) has become one of the leading causes of death worldwide, including in Indonesia. Acute myocardial infarction (AMI), commonly known as a heart attack, is a common heart emergency condition that can be caused by unstable ischemic syndrome. In diagnosing and assessing the severity of this condition, various methods such as clinical evaluation, electrocardiogram, biochemical testing, and invasive and non-invasive imaging are used. One important component in this process is homocysteine levels, an amino acid with sulfur groups involved in the methionine cycle. This study aims to explore the relationship between serum homocysteine levels and the severity of acute myocardial infarction, which is measured based on the Gensini score.

The Importance of Homocysteine Levels in Heart Health

Homocysteine is an amino acid with sulfur groups that plays a crucial role in the methionine cycle, which is involved in providing methyl groups needed in various biochemical processes of the body, including glutathione synthesis. Elevated homocysteine levels have been linked to an increased risk of cardiovascular disease, including coronary heart disease and stroke. High homocysteine levels can be caused by several factors, including poor nutrition, metabolic disorders, and genetic mutations. Therefore, it is essential to monitor homocysteine levels in patients with cardiovascular disease to determine the risk of heart events and to develop effective treatment strategies.

Research Purpose and Methodology

This study aims to explore the relationship between serum homocysteine levels and the severity of acute myocardial infarction, which is measured based on the Gensini score. The method used is analytical observational with a cross-sectional approach. In this study, 50 subjects diagnosed with acute myocardial infarction were included. Their serum homocysteine levels were tested, and coronary angiography examination was carried out to evaluate the condition of the heart vessels. The severity of myocardial infarction was assessed based on the Gensini score, which is a widely used scoring system to evaluate the severity of coronary artery disease.

Results

The average median of the Gensini score obtained from 50 patients was 52 (with a range of 6-94), while the results of examination of serum homocysteine levels were 10.28 ± 4.61 μmol/L. Through the Spearman correlation analysis, it was found that the relationship between serum homocysteine levels and Gensini scores had a value of P = 0.001 and the correlation coefficient r = 0.445. This result indicates that there is a significant relationship between serum homocysteine levels and the severity of acute myocardial infarction, which is associated with a Gensini score.

Conclusion

Based on the results of this study, it can be concluded that there is a significant relationship between serum homocysteine levels and the severity of acute myocardial infarction, which is associated with a Gensini score. This finding supports the importance of measurement of homocysteine levels in the evaluation of patients with acute myocardial infarction and can contribute to the determination of better treatment strategies. The holistic approach in heart health management, which considers homocysteine levels, as well as other risk factors, is very important to improve the quality of life of individuals and reduce the incidence of heart disease.

Additional Analysis

The importance of homocysteine levels in the context of heart health cannot be ignored. This study shows that an increase in homocysteine levels correlates with an increase in the severity of myocardial infarction, which indicates that homocysteine has the potential to be a biomarker for the prediction of the risk of heart events. High homocysteine levels can be caused by several factors, including poor nutrition or metabolic disorders, which can be overcome through lifestyle and dietary changes. Therefore, the holistic approach in heart health management, which considers homocysteine levels, as well as other risk factors, is very important to improve the quality of life of individuals and reduce the incidence of heart disease.

Implications for Clinical Practice

The findings of this study have several implications for clinical practice. Firstly, measurement of homocysteine levels should be included in the evaluation of patients with acute myocardial infarction. Secondly, patients with high homocysteine levels should be advised to make lifestyle and dietary changes to reduce their risk of heart events. Finally, healthcare providers should consider homocysteine levels as a biomarker for the prediction of the risk of heart events.

Limitations of the Study

This study has several limitations. Firstly, the sample size was relatively small, which may limit the generalizability of the findings. Secondly, the study only included patients with acute myocardial infarction, which may not be representative of the general population. Finally, the study did not control for other risk factors that may influence the relationship between homocysteine levels and the severity of myocardial infarction.

Future Research Directions

Future research should aim to replicate the findings of this study in a larger and more diverse sample. Additionally, studies should investigate the relationship between homocysteine levels and other cardiovascular risk factors, such as hypertension and diabetes. Finally, studies should explore the potential of homocysteine as a biomarker for the prediction of the risk of heart events.

Conclusion

In conclusion, this study found a significant relationship between serum homocysteine levels and the severity of acute myocardial infarction, which is associated with a Gensini score. This finding supports the importance of measurement of homocysteine levels in the evaluation of patients with acute myocardial infarction and can contribute to the determination of better treatment strategies. The holistic approach in heart health management, which considers homocysteine levels, as well as other risk factors, is very important to improve the quality of life of individuals and reduce the incidence of heart disease.
Frequently Asked Questions (FAQs) About the Relationship Between Serum Homocysteine Levels and the Severity of Acute Myocardial Infarction

Q: What is homocysteine, and why is it important in heart health?

A: Homocysteine is an amino acid with sulfur groups that plays a crucial role in the methionine cycle, which is involved in providing methyl groups needed in various biochemical processes of the body, including glutathione synthesis. Elevated homocysteine levels have been linked to an increased risk of cardiovascular disease, including coronary heart disease and stroke.

Q: What is the Gensini score, and how is it used in this study?

A: The Gensini score is a widely used scoring system to evaluate the severity of coronary artery disease. It takes into account the location and severity of coronary artery stenosis, as well as the presence of other cardiovascular risk factors. In this study, the Gensini score was used to assess the severity of acute myocardial infarction in patients with high homocysteine levels.

Q: What are the implications of this study for clinical practice?

A: The findings of this study have several implications for clinical practice. Firstly, measurement of homocysteine levels should be included in the evaluation of patients with acute myocardial infarction. Secondly, patients with high homocysteine levels should be advised to make lifestyle and dietary changes to reduce their risk of heart events. Finally, healthcare providers should consider homocysteine levels as a biomarker for the prediction of the risk of heart events.

Q: What are the limitations of this study?

A: This study has several limitations. Firstly, the sample size was relatively small, which may limit the generalizability of the findings. Secondly, the study only included patients with acute myocardial infarction, which may not be representative of the general population. Finally, the study did not control for other risk factors that may influence the relationship between homocysteine levels and the severity of myocardial infarction.

Q: What are the potential biomarkers for the prediction of the risk of heart events?

A: Homocysteine levels have the potential to be a biomarker for the prediction of the risk of heart events. Elevated homocysteine levels have been linked to an increased risk of cardiovascular disease, including coronary heart disease and stroke.

Q: What are the lifestyle and dietary changes that can reduce the risk of heart events?

A: Patients with high homocysteine levels should be advised to make lifestyle and dietary changes to reduce their risk of heart events. These changes may include:

Eating a balanced diet that is rich in fruits, vegetables, and whole grains
Increasing physical activity levels
Maintaining a healthy weight
Reducing stress levels
Avoiding smoking and excessive alcohol consumption

Q: What are the future research directions for this study?

A: Future research should aim to replicate the findings of this study in a larger and more diverse sample. Additionally, studies should investigate the relationship between homocysteine levels and other cardiovascular risk factors, such as hypertension and diabetes. Finally, studies should explore the potential of homocysteine as a biomarker for the prediction of the risk of heart events.

Q: What are the potential applications of this study in the field of cardiovascular medicine?

A: The findings of this study have several potential applications in the field of cardiovascular medicine. Firstly, measurement of homocysteine levels can be used as a biomarker for the prediction of the risk of heart events. Secondly, patients with high homocysteine levels can be advised to make lifestyle and dietary changes to reduce their risk of heart events. Finally, healthcare providers can use the Gensini score to assess the severity of coronary artery disease in patients with high homocysteine levels.

Q: What are the potential implications of this study for public health policy?

A: The findings of this study have several potential implications for public health policy. Firstly, public health campaigns can be designed to raise awareness about the importance of homocysteine levels in heart health. Secondly, healthcare providers can be educated about the use of homocysteine levels as a biomarker for the prediction of the risk of heart events. Finally, public health policies can be developed to promote healthy lifestyle and dietary habits in the general population.