NEW YORK, June 27 (Praxis Press) Circulating homocysteine levels can be used to predict survival in patients with stable coronary artery disease. The prognostic value of serum homocysteine levels, obtained in the acute phase in patients with myocardial infarction or unstable angina, however, is unknown. To test this hypothesis, Omland and colleagues measured the serum homocysteine levels of a total of 579 patients with Q-wave myocardial infarction (n=163), non- Q-wave myocardial infarction (n=210 patients), and unstable angina pectoris (n=206) (see paper). They then examined all-cause mortality after 628 days and found that 65 patients died. Serum homocysteine level was significantly lower in long-term survivors compared with nonsurvivors. The serum homocysteine level on hospital admission is an independent predictor of long-term survival in patients with acute coronary syndromes.