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A Study of Srum Homocysteine Level in Ischaemic Stoke
Kaushik Paul1, Ramakrishna Mr1
1Navodaya Medical College, Kolkata.
Insights
Hyperhomocysteinemia is a significant risk factor for ischemic stroke. Measuring serum homocysteine levels can aid in stroke investigation and management with vitamin supplementation.
Area of Science:
- Neurology
- Vascular Medicine
- Biochemistry
Background:
- Stroke is a leading global cause of death, with infarction accounting for 85% of cases.
- Hyperhomocysteinemia is linked to atherosclerosis and an increased risk of cerebrovascular events.
Purpose of the Study:
- To investigate the association between serum homocysteine levels and ischemic stroke.
- To determine the role of hyperhomocysteinemia as a risk factor for stroke.
Main Methods:
- A study involving 50 patients admitted with stroke symptoms over 18 months.
- Clinical examination, CT scan, and laboratory tests including serum homocysteine levels were performed.
- Risk factors and preceding symptoms were recorded through patient and relative interviews.
Main Results:
- Serum homocysteine levels were significantly elevated in patients with ischemic stroke.
- Higher homocysteine levels were observed in non-diabetics, younger patients (<65 years), and those with normal lipid profiles compared to their counterparts.
- Elevated homocysteine levels were also noted in hypertensives, though not statistically significant.
Conclusions:
- Hyperhomocysteinemia is identified as a crucial risk factor for ischemic stroke.
- Serum homocysteine measurement is recommended for investigating ischemic stroke cases.
- Multivitamin therapy (B12, folic acid, pyridoxine) is suggested for patients with elevated homocysteine levels to reduce stroke risk.
Abstract:
Stroke remains the second leading cause of death world wide after ischaemic heart disease. Stroke occurs mainly due to infarction which accpounts for 85% of etiological factors and 15% due to hemorrhage. Hyperhomocysteinemia is associated with premature atherosclerosis and vascular events and it is an important risk factor for cerebrovascular accidents.
Material:
Case will be selected from patients admitted to medical wards in Navodaya Medical College, Raichur. Duration based study with a minimum of 50 cases for a period of 18 months from august 2019. In all patients admitted with symptoms suggestive of stroke careful methodical examination of central nervous system carried out recording all physical signs in order. In all cases with the help of close relatives the preceding symptoms and risk factors were enquired all patients were subjected to CT scan brain, CBC, FBS, PPBS, lipid profile and serum homocysteine levels were done.
Observation:
In our study we observed that the serum homocysteine levels were elevated in ischemic stroke significantly. The mean serum homocysteine levels were higher in non diabetics(29.57 micromole/ litre) than diabetics (20.75 micromole/litre) and difference was statistically significant (P<0.001). Mean serum Homocysteine levels were higher in age group <65 years(28.73 micromole/litre) than patient age >65 years (20.50 micromole/litre) and the difference was statistically significant (p<0.001). Mean serum heomocysteine levels were higher in hypertensives (26.73 micromole/litre) than normotensive (23.28 micromole/litre) however the difference was statistically not significant (p>0.001).The mean serum homocysteine levels were higher in patients with normal lipid profile(30.97 micromole/litre) than patients with dyslipidemia (21.92 micromole/litre) and the difference was statistically significant (p<0.001).
Conclusion:
The present study revealed that hyperhomocysteinemia appears to be an important risk factor for ischemic stroke. It is therefore important to use serum homocysteine as an important tool to investigate all cases of ischemic stroke and if serum homocysteine is elevated patient should be put on multivitamins containing vitamin B12, folic acid and pyridoxine to reduce serum homocysteine levels.
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