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Plasma homocysteine level and the course of ischemic stroke

Jarosław Pniewski1, Małgorzata Chodakowska-Zebrowska, Radosław Woźniak

  • 1Department of Neurodegenerative Disorders, Medical Research Centre PAN, 5 Pawiński St., 02-106 Warsaw, Poland. pniewski@cmdik.pan.pl.

Acta Neurobiologiae Experimentalis
|August 21, 2003
PubMed

Insights

High homocysteine (Hcy) levels significantly worsen outcomes for ischemic stroke (IS) patients. Mild hyperhomocysteinemia (MHcy) was linked to an 11.78-fold increased risk of poor recovery after stroke.

Area of Science:

  • Neurology
  • Clinical Biochemistry
  • Cardiovascular Research

Background:

  • Elevated homocysteine (Hcy) levels are implicated in negative ischemic stroke (IS) progression.
  • Oxidative stress may mediate the detrimental effects of Hcy on IS.

Purpose of the Study:

  • To evaluate the impact of blood Hcy levels on the 3-month prognosis of patients diagnosed with IS.

Main Methods:

  • Seventy-five patients with first-ever IS (mean age 68.27 years) were analyzed.
  • Exclusion criteria included TACS symptoms and diminished consciousness.
  • Mild hyperhomocysteinemia (MHcy) defined as Hcy > 15 micromol/l.
  • Patient recovery assessed using the Rankin Scale at 3 months (Good Recovery: 0-2, Bad Recovery: 3-5, Death).

Main Results:

  • MHcy was present in 14.5% of patients with good recovery (GR) versus 66.7% with bad recovery (BR).
  • A statistically significant association was found between MHcy and poor outcomes (P = 0.0005).
  • MHcy was associated with an 11.78-fold increased risk of bad recovery (95% CI 2.93-47.42).

Conclusions:

  • Elevated homocysteine levels are a significant predictor of poor prognosis in ischemic stroke patients.
  • Mild hyperhomocysteinemia substantially increases the risk of adverse outcomes 3 months post-stroke.

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