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Homocysteine testing in patients with acute ischemic stroke
Cheryl D Bushnell1, Larry B Goldstein
1Department of Medicine (Neurology), Duke University Medical Center, Durham, NC 27710, USA. bushn002@mc.duke.edu
Neurology
|November 27, 2002
Summary
This study found no patient characteristics linked to high total homocysteine (tHcy) levels in acute ischemic stroke patients. Physicians
Area of Science:
- Neurology
- Clinical Chemistry
Background:
- Elevated total homocysteine (tHcy) is a potential risk factor for ischemic stroke.
- Understanding factors associated with tHcy levels and testing is crucial for clinical management.
Purpose of the Study:
- To identify pretesting factors associated with elevated total homocysteine (tHcy) levels in acute ischemic stroke patients.
- To determine patient characteristics influencing physicians' decisions to order tHcy tests.
Main Methods:
- Retrospective analysis of 674 adult ischemic stroke patients admitted between January 1997 and December 1999.
- Classification of stroke subtypes using TOAST criteria.
- Univariate and multivariable logistic regression analyses to identify associations with tHcy levels and testing.
Main Results:
- Only 19.4% of patients were tested for tHcy.
- No patient characteristics, including age, sex, or stroke subtype, were associated with elevated tHcy levels.
- Younger age, hyperlipidemia, diabetes, cardioembolic, and small-vessel stroke subtypes were associated with tHcy testing.
Conclusions:
- Elevated tHcy levels in acute ischemic stroke patients were not linked to any studied patient characteristics.
- Further research is required to identify factors guiding tHcy testing selection and enhance diagnostic utility.