Association of Hyperhomocysteinemia with Stroke Recurrence after Initial Stroke


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KUMRAL E., SARUHAN G. , AKTERT D. , ORMAN M.

JOURNAL OF STROKE & CEREBROVASCULAR DISEASES, cilt.25, ss.2047-2054, 2016 (SCI İndekslerine Giren Dergi)

Özet

Background and purpose: Homocysteine (Hcy) is closely associated with stroke.
Despite the fact that Hcy has consistently been shown to predict development of
recurrent stroke, prior studies on the association of Hcy and stroke subtypes have
been inconclusive. Methods: Data from the Ege Stroke Registry were examined
and 5-year follow-up data were analyzed. Multivariate survival analyses were undertaken
using Cox proportional hazards models to determine the prognostic value
of Hcy in different ischemic stroke subtypes. Results: Of the 9522 patients with
stroke, 307 (27%) with hyperhomocysteinemia (hHcy) had recurrent stroke. Univariate
Cox regression model showed that hHcy group was associated with recurrent
stroke (crude hazard ratio [HR] 1.16; 95% CI 1.02-1.30). But there was no such
association in multivariate regression models (adjusted HR 1.11; 95% CI .97-
1.26). hHcy was not associated with any ischemic stroke subtypes at 5 years.
Univariate Cox regression model showed that hHcy group was associated with
overall cardiovascular events (crude HR 1.44; 95% CI 1.32-1.57). However, this
association no longer existed in multivariate regression models (adjusted HR 1.01;
95% CI .93-1.12). Higher plasma Hcy group was significantly associated with higher
mortality compared with normal plasma Hcy group (OR 1.83; 95% CI .45-2.32).
Conclusions: Our results showed that elevated Hcy is not associated independently
with stroke recurrence and overall cardiovascular events in patients with
ischemic stroke. There was no association between the hHcy and stroke recurrence
in the stroke subtypes within 5 years.