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Hyperhomocysteinemia as an independent risk factor for cardioembolic stroke in the Turkish population

Nida Tascilar1, Sureyya Ekem, Esra Aciman

  • 1Department of Neurology, Zonguldak Karaelmas University Medical Faculty, Kozlu/Zonguldak, Turkey.

The Tohoku Journal of Experimental Medicine
|July 30, 2009
PubMed

Insights

High homocysteine levels are common in Turkish patients with atherosclerotic and cardioembolic stroke. However, hyperhomocysteinemia is an independent risk factor only for cardioembolic stroke.

Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Biochemistry

Background:

  • Homocysteine, an amino acid intermediate, can cause vascular injury and atherosclerotic plaque instability.
  • Elevated homocysteine levels are linked to hyperlipidemia and lipoprotein(a), and inversely to HDL cholesterol.
  • Previous studies on homocysteine's association with stroke subtypes and risk factors show inconsistent results, potentially due to ethnic variations.

Purpose of the Study:

  • To investigate the role of serum homocysteine levels in Turkish patients with atherosclerotic stroke and cardioembolic stroke.
  • To determine if hyperhomocysteinemia is an independent risk factor for these stroke subtypes in the Turkish population.

Main Methods:

  • Serum homocysteine, lipoprotein(a), and traditional stroke risk factors (hypertension, diabetes, smoking) were measured.
  • 103 patients with large-vessel atherosclerotic stroke, 37 with cardioembolic stroke, and 37 controls were analyzed.
  • Statistical analysis included logistic regression and correlation tests.

Main Results:

  • Hypertension was a significant risk factor across all patient groups (p = 0.001).
  • Hyperhomocysteinemia (≥15.90 µmol/L) was more prevalent in both atherosclerotic (p=0.0435) and cardioembolic stroke patients (p=0.007).
  • Hyperhomocysteinemia emerged as an independent risk factor solely for cardioembolic stroke (p=0.023, OR: 5.745) and correlated positively with lipoprotein(a) in atherosclerotic stroke (r=0.227, p=0.035).

Conclusions:

  • Hyperhomocysteinemia is frequently observed in Turkish patients with both large-vessel atherosclerotic and cardioembolic stroke.
  • Elevated homocysteine is an independent risk factor specifically for cardioembolic stroke within this population.
  • The findings highlight the importance of considering homocysteine levels in stroke risk assessment, particularly for cardioembolic events.

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