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Which Ischemic Stroke Subtype Is Associated with Hyperhomocysteinemia?

Levent Gungor1, Murat Polat1, Mehlika Berra Ozberk1

  • 1Faculty of Medicine, Departments of Neurology, Biochemistry, and Molecular Genetics, Ondokuz Mayis University, Samsun Turkey.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|April 18, 2018
PubMed
Summary

Elevated serum homocysteine levels are linked to a higher risk of ischemic stroke caused by intracranial stenosis in adults. This finding suggests homocysteine-lowering therapies may aid in preventing strokes related to intracranial atherosclerosis.

Keywords:
Ischemic strokehomocysteineintracranial stenosissubtype

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Area of Science:

  • Neurology
  • Vascular Medicine
  • Biochemistry

Background:

  • Stroke remains a significant global health challenge, necessitating precise etiological classification for effective prophylaxis.
  • Elevated serum homocysteine, an endothelial toxin, is a known risk factor for stroke.
  • Understanding the association between homocysteine levels and specific ischemic stroke subtypes is crucial for targeted prevention strategies.

Purpose of the Study:

  • To investigate the correlation between serum total homocysteine levels and specific atherothrombotic ischemic stroke subtypes.
  • To determine if elevated homocysteine is associated with particular types of ischemic stroke.

Main Methods:

  • A retrospective analysis of 262 ischemic stroke patients aged 18-65.
  • Ischemic stroke subtypes were classified using the Causative Classification System.
  • Patient data, including demographics, vascular risk factors, and serum levels of homocysteine, B12, and folic acid, were examined.

Main Results:

  • Hyperhomocysteinemia (≥16 µmol/L) was observed in 37.79% of patients.
  • Elevated homocysteine was significantly more prevalent in strokes due to intracranial stenosis (72.41%) compared to other subtypes.
  • Higher homocysteine levels were also associated with male gender and smoking.

Conclusions:

  • Elevated serum homocysteine is significantly correlated with ischemic strokes attributed to intracranial large artery stenosis in young and middle-aged individuals.
  • This association highlights the potential role of homocysteine-lowering therapies in the prophylaxis of intracranial atherosclerosis-related strokes.