Final answer:
The African American woman who is sedentary and has elevated homocysteine is most at risk for developing coronary artery disease.
Step-by-step explanation:
The patient who is most at risk for developing coronary artery disease is the African American woman who is sedentary and has elevated homocysteine. While each of the other patients in the options has some risk factors for coronary artery disease, this patient has multiple risk factors that contribute to a higher risk. Sedentary lifestyle, especially when combined with elevated homocysteine levels, increases the risk of developing plaque in the arteries, leading to coronary artery disease. Additionally, being African American and female are also demographic risk factors for developing coronary artery disease.