Plasma Homocysteine Levels Predict the Risk of Acute Cerebral Infarction in Patients with Carotid Artery Lesions
1Department of Neurosurgery, The First Hospital of Jilin University, 71 Xinmin Street, Changchun, 130021, People's Republic of China.
Insights
Elevated plasma homocysteine (Hcy) levels are linked to a higher risk of acute cerebral infarction in patients with carotid artery lesions. Higher Hcy levels correlated with increased carotid plaque and arterial stenosis.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Biochemistry
Background:
- Elevated plasma homocysteine (Hcy) is a potential risk factor for cerebrovascular diseases.
- Carotid artery lesions are a significant contributor to acute cerebral infarction.
- Understanding the relationship between Hcy and carotid artery pathology is crucial for stroke prevention.
Purpose of the Study:
- To investigate the association between elevated plasma homocysteine levels and the risk of acute cerebral infarction in patients with carotid artery lesions.
- To determine if Hcy levels correlate with the presence and severity of carotid artery stenosis and plaque formation.
Main Methods:
- A cohort of 78 patients with carotid artery lesions was divided into high Hcy (>15 umol/L) and low Hcy (≤15 umol/L) groups.
- High-resolution B-mode ultrasound assessed extracranial carotid artery intima media thickness (IMT), infarcts, plaques, and stenosis.
- 3 T MR imaging evaluated intracranial cerebral artery stenosis.
Main Results:
- Plasma Hcy levels showed no significant differences based on gender, age, blood pressure, diabetes, or hyperlipidemia.
- The high Hcy group exhibited a significantly higher incidence of carotid plaque and severe intracranial and extracranial arterial stenosis compared to the low Hcy group.
- Plasma Hcy levels positively correlated with IMT, and the total and unstable plaque counts.
Conclusions:
- Elevated plasma homocysteine levels are significantly correlated with increased carotid plaque formation and arterial stenosis (both extra- and intracranial).
- These findings suggest that elevated Hcy is a risk factor for acute cerebral infarction in patients with carotid artery lesions.
Abstract:
This study examined the association between elevated plasma homocysteine (Hcy) levels and the risk of acute cerebral infarction in patients with carotid artery lesions. A total of 78 patients were divided into two groups, the high Hcy group (n = 38; Hcy levels >15 umol/L) and the low Hcy group (n = 40; Hcy levels ≤15 umol/L). High-resolution B-mode ultrasounds were performed to assess intima media thickness (IMT), infarcts, plaques, and stenosis in the extracranial carotid artery of these patients. All patients underwent 3 T MR scanners to evaluate cerebral artery stenosis in the intracranial cerebral artery. The plasma Hcy levels did not show any statistically significant differences when comparisons were based on gender, age, blood pressure, diabetes, hyperlipidemia, and systolic and diastolic pressures. Importantly, the incidence of carotid plaque and severe stenosis of intracranial and extracranial artery were significantly higher in the high Hcy group compared to the low Hcy group. Pearson's test indicated that plasma Hcy levels positively correlated with IMT, total number of plaques and unstable plaques. Overall, the elevated plasma Hcy levels correlated with increased frequency of carotid plaque formation, extra- and intracranial arterial stenosis, and the degree of stenosis. In conclusion, we find a significant correlation between elevated plasma Hcy levels and the increased incidence of acute cerebral infarction in patients with carotid artery lesions.
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