Unravelling the Role of Apolipoprotein-B, Lipoprotein(a), and Homocysteine in Myocardial Infarction: A Tertiary Hospital Case-Control Analysis

OBJECTIVE Cardiovascular disease (CVD) causes approximately 17.9 million deaths globally each year, making it one of the leading causes of mortality. Around 15.00-20.00% of cardiovascular events occur without the presence of traditional risk factors. Some less commonly detected risk factors in CVD patients include hyperhomocysteinemia, metabolic syndrome, lipoprotein(a) (Lp(a)), apolipoprotein B (Apo-B), and elevated procoagulant levels. High levels of homocysteine (Hcy), Lp(a), and Apo-B are linked to an increased risk of myocardial infarction (MI). This study aimed to evaluate the prevalence of elevated Apo-B, Lp(a), and Hcy levels in MI patients from rural areas of Coimbatore District, Tamil Nadu, India. METHODS This case-control study was conducted at a tertiary care hospital from January to December 2021, following institutional ethics committee approval (IHEC/188/BIOCHEMISTRY/2020). Fifty MI patients (aged 30-80 years) and 50 age-sex matched healthy controls were recruited after obtaining informed written consent. Patients with previous MI, CAD, chronic kidney disease, or those on lipid-lowering therapy were excluded. Blood samples were collected under sterile conditions an