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Emerging risk factors for ischemic stroke.

R Abbate1, F Sofi, D Brogi

  • 1Dipartimento Area Critica Medico-Chirurgica, Università di Firenze, Centro Trombosi, AO Careggi, Italy.

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
|May 30, 2003
PubMed
Summary
This summary is machine-generated.

High homocysteine (Hcy) levels increase cerebrovascular disease risk, independent of other factors. Lowering Hcy through vitamin supplementation is being investigated to prevent stroke recurrence.

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Area of Science:

  • Neurology
  • Cardiovascular Science
  • Genetics

Background:

  • Elevated homocysteine (Hcy) is increasingly recognized as a significant risk factor for cerebrovascular diseases.
  • Prospective studies indicate a dose-dependent relationship between Hcy levels and vascular risk.

Purpose of the Study:

  • To summarize the evidence linking homocysteine to cerebrovascular disease risk.
  • To explore the role of MTHFR polymorphism and Hcy in specific conditions like dissection and atrial fibrillation.
  • To highlight ongoing trials investigating Hcy-lowering interventions.

Main Methods:

  • Review of six prospective studies examining homocysteine levels and cerebrovascular disease.
  • Analysis of Hcy levels in relation to traditional cardiovascular risk factors, smoking, and hypertension.
  • Inclusion of recent findings on MTHFR polymorphism and preliminary data on atrial fibrillation.

Main Results:

  • Vascular risk associated with homocysteine is dose-dependent and independent of traditional risk factors.
  • A synergistic effect of Hcy with smoking and hypertension on vascular risk was observed.
  • Hyperhomocysteinemia and MTHFR polymorphism are identified as independent risk factors for dissection.
  • Preliminary data suggest hyperhomocysteinemia is a risk factor for cerebrovascular events in atrial fibrillation patients.

Conclusions:

  • Homocysteine is a significant, independent risk factor for cerebrovascular disease.
  • Further research and intervention trials are warranted to assess the efficacy of lowering Hcy levels for stroke prevention.