Association of High Blood Homocysteine and Risk of Increased Severity of Ischemic Stroke Events

Harris, Salim; Rasyid, Al; Kurniawan, Mohammad; Mesiano, Taufik; Hidayat, Rakhmad

doi:10.1055/s-0038-1667141

Cited by 17 publications

(10 citation statements)

References 22 publications

(28 reference statements)

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“…Homocysteine (Hcy), a key metabolite of methionine, is proposed to be actively involved in numerous biochemical reactions, with compelling evidences indicating that hyperhomocysteinemia (HHcy) is a candidate risk factor for ischemic stroke [3–6]. Nonetheless, the association between homocysteine and stroke is still controversial [7].…”

Section: Introductionmentioning

confidence: 99%

Elevated homocysteine as an independent risk for intracranial atherosclerotic stenosis

Liu

Song

Hou

et al. 2019

Aging

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To investigate the association of homocysteine concentration with intracranial atherosclerotic stenosis (ICAS), we assessed 933 acute ischemic stroke patients (346 with ICAS, 587 without ICAS) and 798 non-stroke controls (175 with ICAS, 623 without ICAS) with magnetic resonance angiography (MRA). Homocysteine concentration was found to be significantly higher in participants with ICAS than those without ICAS. In logistic regression analyses, homocysteine concentration was significantly associated with ICAS both in patients (OR: 1.04; 95% CI: 1.01–1.08; P=0.008) and controls (OR: 1.10; 95% CI: 1.06–1.15; P<0.001) for 1 μmol/L increment in homocysteine. Compared with the lowest quartile, the second (OR:1.53; 95% CI: 1.01-2.33), third (OR:1.71; 95% CI: 1.14 -2.60) and fourth (OR:2.48; 95%CI: 1.63-3.81) quartiles were independent predictors of ICAS in patients (P for trend<0.001); the third (OR:1.99; 95% CI: 1.18-3.40) and fourth (OR:2.36; 95%CI: 1.38-4.10) quartiles were independent predictors of ICAS in controls (P for trend<0.001). Hence, elevated homocysteine might be an independent risk for ICAS.

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Section: Introductionmentioning

confidence: 99%

Elevated homocysteine as an independent risk for intracranial atherosclerotic stenosis

Liu

Song

Hou

et al. 2019

Aging

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“…Elevated levels of homocysteine (>15 micromoles/liter) is considered a major risk factor for non-hemorrhagic stroke [2]. Homocysteine gets eliminated from the body through vitamin B12 metabolism and folate metabolism finally converting into adenosine which gets cleared from the body.…”

Section: Discussionmentioning

confidence: 99%

“…It is being hypothesized that homocysteine is highly reactive amino acid and potentiates oxidation of very low-density lipoprotein which is toxic to endothelial cells and can cause arterial and venous thrombosis [1]. Consistently, the association between hyperhomocysteinemia and stroke has been well documented in the literature [2]. However, there are limited reports revealing stroke events in the pediatric population affected by hyperhomocysteinaemia.…”

Section: Introductionmentioning

confidence: 99%

A Rare Case of Hyperhomocysteinemia-associated Thrombotic Stroke in the Pediatric Age Group

Dave

Dalal

Patel

et al. 2019

Cureus

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Association between hyperhomocysteinemia and stroke has been well documented in the literature. However, there are limited reports revealing stroke events in the pediatric population affected by hyperhomocysteinemia. Herein, we present a case which shows genetically inherited hyperhomocysteinemia leading to a stroke event in a 14-year-old child. The patient presented to the outpatient clinic with dizziness and nonprojectile vomiting since the previous day without any history of weakness in the extremities or unconsciousness. The preliminary neurologic examination showed positive right-sided cerebellar signs like ataxia on physical examination and the final diagnostic workup confirmed acute non-hemorrhagic bilateral cerebellar and medullary infarction with hyperhomocysteinemia. We discuss the case presentation, diagnostic workup, and management strategies.

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“…Similar results were shown in other reports. [ 17 ] H type hypertension is defined as hypertension with plasma Hcy levels over 10 μmol/L [ 18 , 19 ]. In China, the proportion of H type hypertension in patients with primary hypertension was as high as 75% [ 2 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

The prevalence, relative risk factors and MTHFR C677T genotype of H type hypertension of the elderly hypertensives in Shanghai, China: a cross-section study

Qian

Cao

Zhang

et al. 2021

BMC Cardiovasc Disord

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Background H type hypertension is defined as homocysteine (Hcy) ≥ 10 μmol/L in combination with primary hypertension. Studies demonstrated that the existence of hyperhomocysteine (HHcy) in hypertensive exacerbates the poor outcome of cardiocerebral incidents. This study was to investigate the current epidemic situation of H type hypertension and determine the risk factors in order to find intervention targets for H type hypertensives. Methods We conducted a cross-sectional study using cluster sampling design in Shanghai, China from July 2019 and April 2020. 23,652 patients with primary hypertension were enrolled in this study. Their medical information was recorded, and the level of Hcy concentrations and methylenetetrahydrofolate reductase (MTHFR) C677T polymorphisms were detected. Results In total, 22,731 of 23,652 patients were recorded. The mean age was 68.9 ± 8.6 y and 43% were men. 80.0% of the enrolled patients had H type hypertension. The frequency of allele T was 40.9%, and the proportions of the CC, CT, and TT genotypes were 36.1%, 46.0%, and 17.9%, respectively. Compared with the TT genotype, the plasma Hcy concentration levels were lower in patients with the CC/CT genotype (18.96 ± 13.48 μmol/L vs. 13.62 ± 5.20/14.28 ± 5.36, F = 75.04, p < 0.01). The risk for H type hypertension was higher in elderly people. Men had ~ 5.55-fold odds of H type hypertension compared with women. Patients with CT genotype and TT genotype had ~ 1.36- and ~ 2.76-fold odds of H type hypertension compared with those with CC genotype, respectively. Smoking and diabetes were not significantly associated with H type hypertension. Conclusions The prevalence of H type hypertension in patients with primary hypertension was 80.0%, which was higher than the 75% found in prior report in China. Age, gender, and MTHFR C677T polymorphisms rather than smoking and diabetes were independently associated with H type hypertension.

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Association of High Blood Homocysteine and Risk of Increased Severity of Ischemic Stroke Events

Cited by 17 publications

References 22 publications

Elevated homocysteine as an independent risk for intracranial atherosclerotic stenosis

Elevated homocysteine as an independent risk for intracranial atherosclerotic stenosis

A Rare Case of Hyperhomocysteinemia-associated Thrombotic Stroke in the Pediatric Age Group

The prevalence, relative risk factors and MTHFR C677T genotype of H type hypertension of the elderly hypertensives in Shanghai, China: a cross-section study

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