Are plasma homocysteine levels related to neurological severity and functional outcome after ischemic stroke in the Korean population?

Song, In‐Uk; Kim, Joong‐Seok; Ryu, Seon-Young; Lee, Sang Bong; Lee, Seung-Jae; Jeong, Du-Shin; Kim, Yeong-In; Lee, Kwang Soo

doi:10.1016/j.jns.2008.11.011

Cited by 21 publications

(14 citation statements)

References 27 publications

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“…Similar findings reported that plasma Hcy levels have no value as predictors of functional disability in Asian patients with stroke (Mizrahi et al, 2005; Song et al, 2009). However, the Mizrahi et al (2005) study assessed patient outcome with Function Independent Measure scores instead of mRS scores, and those two studies recruited both younger and elderly patients.…”

Section: Discussionsupporting

confidence: 83%

No Association between Elevated Total Homocysteine Levels and Functional Outcome in Elderly Patients with Acute Cerebral Infarction

Wang

Gao

et al. 2017

Front. Aging Neurosci.

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Background: An elevated plasma total homocysteine (tHcy) level is an independent risk factor for vascular events. The aim of the present study was to investigate the association between tHcy levels in the acute phase of cerebral infarction and functional outcome among elderly patients.Methods: Between October 2009 and December 2012, we recruited 594 elderly patients (age > 75) with first-onset acute cerebral infarction who were consecutively admitted to the Department of Neurology of Tianjin Huanhu Hospital, China. Levels of tHcy and other biochemical values were measured within 24 h after admission. tHcy values were classified according to quartiles (<9.94; 9.94 to <12.7; 12.7 to <16.8; and ≥16.8 μmol/L). We examined the relationship between tHcy levels at admission and modified Rankin Scale scores (mRS) using univariate and multivariate analyses. Patients were followed up at 3 months and 1 year after stroke.Results: Within 3 months after stroke, 64 patients died, 37 had recurrent ischemic stroke, and 22 were lost to follow-up; thus, 471 patients were reviewed and analyzed. By the time of the 1-year follow-up, an additional 48 patients had died, 44 had recurrent ischemic stroke, and 40 had been lost to follow-up; the remaining 339 patients were thus reviewed and analyzed. Elevated tHcy levels were not associated with functional outcome among elderly patients with acute cerebral infarction (p > 0.05). Only the National Institutes of Health Stroke Scale score was associated with a poor outcome after adjusting for confounders at 3 months and 1 year (adjusted odds ratio, 1.38; 95% CI, 1.28–1.49; p < 0.01; adjusted odds ratio, 1.34; 95% CI, 1.25–1.44; p < 0.01, respectively).Conclusion: Among elderly patients with acute cerebral infarction, elevated tHcy at admission was not a predictive factor of outcome at 3 months and 1 year after stroke onset.

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Section: Discussionsupporting

confidence: 83%

No Association between Elevated Total Homocysteine Levels and Functional Outcome in Elderly Patients with Acute Cerebral Infarction

Wang

Gao

et al. 2017

Front. Aging Neurosci.

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“…Stoke itself may partly contribute to the increase in homocysteine levels, 1,15,16 but in this study the severity of stroke among the four groups was similar, and the PSG and detection of plasma homocysteine levels were both performed in the same phase of stroke in all patients; this reduced the impact of the degree and phase of stroke on OSA and homocysteine levels. In addition, most previous studies [15][16][17][18] have not confirmed an association between homocysteine levels and stroke severity.…”

Section: Discussionmentioning

confidence: 90%

Association between plasma homocysteine levels and obstructive sleep apnoea in patients with ischaemic stroke

Chen

et al. 2011

Journal of Clinical Neuroscience

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“…10 However, the relationship between high plasma homocysteine levels and stroke outcomes remains controversial because some studies have found an association, whereas others have not. 6,7,11 The mechanisms underlying these associations are incompletely understood; however, some hypothetical causes might lead to functional disability. 12 Our study has several limitations.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 There are also a few studies reporting a relationship between homocysteine and functional disability in the acute phase of stroke. 6,7 However, whether high homocysteine levels are a risk factor for acute stroke complications, such as early neurological deterioration (END), has not been well addressed. Therefore, the purpose of this study was to investigate the possible relationship between homocysteine levels and END in a large prospective multicentered study.…”

mentioning

confidence: 99%

Homocysteine as a Predictor of Early Neurological Deterioration in Acute Ischemic Stroke

Kwon

Lee

Bae

et al. 2014

Stroke

145

127

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We examined total homocysteine by quartiles of increasing levels to evaluate for possible threshold effects. Baseline and clinical Background and Purpose-Hyperhomocysteinemia is a well-known risk factor for vascular disease. However, its action, mechanism, and role in the acute phase of stroke have not been determined. We tried to determine whether an association existed between elevated serum homocysteine levels and early neurological deterioration (END) in patients with acute ischemic stroke. Methods-We performed a secondary analysis from the Cilostazol in Acute Ischemic Stroke Treatment (CAIST) trial, which was a double-blinded, randomized, multicenter trial, assessing the noninferiority of cilostazol over aspirin within 48 hours of an acute ischemic stroke. END was defined as an increase of ≥1 point in motor power or an increase of ≥2 points in the total National Institute of Health Stroke Scale score within 7 days. Results-The mean (±SD) serum homocysteine level was 11.4±4.7 μmol/L. Of the 396 patients studied, 57 (14.4%) patients worsened during the 7 days after inclusion. Most (68%) of the END cases occurred within the first 24 hours after treatment. High levels (>10.3 μmol/L) of serum homocysteine were independent predictors for END (third quartile odds ratio, 3.45; 95% confidence intervals, 1.25-9.50; P=0.016; fourth quartile odds ratio, 3.36; 95% confidence intervals 1.18-9.52; P=0.023) in multivariate analysis. Conclusions-Patients

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Are plasma homocysteine levels related to neurological severity and functional outcome after ischemic stroke in the Korean population?

Cited by 21 publications

References 27 publications

No Association between Elevated Total Homocysteine Levels and Functional Outcome in Elderly Patients with Acute Cerebral Infarction

No Association between Elevated Total Homocysteine Levels and Functional Outcome in Elderly Patients with Acute Cerebral Infarction

Association between plasma homocysteine levels and obstructive sleep apnoea in patients with ischaemic stroke

Homocysteine as a Predictor of Early Neurological Deterioration in Acute Ischemic Stroke

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