Many patients who have a myocardial infarction have normal cholesterol levels and no other known risk factors. An elevated plasma level of homocysteine correlates with an increased risk for coronary artery disease and is an important measurable biomarker. An increase in plasma concentration of total homocysteine, hyperhomocysteinemia, is an important independent risk factor for vascular disease. The authors discuss the relationship between coronary artery disease and homocysteine levels, and provide a literature review and nursing implications.

Age-adjusted rates of deaths due to cardiovascular disease have declined by more than 50% in the past 25 years among whites and blacks of both sexes.1 This decrease is due, in part, to improved treatment at the acute care level and to effective primary prevention, such as reducing plasma levels of lipids; smoking cessation; and controlling blood pressure, blood glucose levels in patients with diabetes, and weight.1,2 As important as established...

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