Role of homocysteine, vitamins B12, B6, B1, and folate in Saudi patients with premature acute coronary syndrome.
Alfaraidy Khalid K, Mohamed Ayman A, Woodman Alexander A, Al-Ansari Rehab R et al.
Homocysteine (HCY) has been implicated in cardiovascular disease through adverse effects on vascular endothelium, oxidative stress, and thrombogenic pathways. Saudi Arabia has a young population and an increasing burden of cardiovascular disease, yet regional data on HCY and B-vitamin profiles in premature acute coronary syndrome (ACS) remain limited. This single-center cross-sectional exploratory study evaluated serum HCY, vitamins B12, B6, B1, and folate levels in 80 patients with premature ACS at King Fahd Military Medical Complex (KFMMC), Dhahran, Saudi Arabia. Premature ACS was defined as ACS occurring in men aged <=55 years and women aged <=65 years. Clinical, laboratory, electrocardiographic, echocardiographic, angiographic, and SYNTAX score II 2020 data were collected. Spearman correlation showed a weak but statistically significant inverse association between HCY and folate (rho = -0.254, p = 0.040; approximate R2 = 0.065), whereas correlations between HCY and vitamins B12, B1, and B6 were not statistically significant. Most patients had low SYNTAX score categories, and exploratory ordinal regression suggested associations between selected biomarkers/clinical variables and SYNTAX score category; however, these findings should be interpreted cautiously because of the small sample size, absence of a control group, and risk of model instability. The study provides preliminary descriptive data on HCY and B-vitamin status among Saudi patients with premature ACS and highlights the need for larger, controlled, multicenter studies incorporating dietary assessment and genetic determinants such as MTHFR polymorphisms.