Changes in total homocysteine levels after acute stroke and recurrence of stroke

Abstract It is not known how total homocysteine (tHcy) levels change during the transition from acute stroke to post-stroke convalescence or whether tHcy changes occurring after the acute period are associated with recurrence of cerebro-cardiovascular events. Levels of tHcy were measured during acut...

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Autores principales:	Zhihong Shi, Shuling Liu, Yalin Guan, Meilin Zhang, Hui Lu, Wei Yue, Biao Zhang, Mingzi Li, Jing Xue, Yong Ji
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2018
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/a32f817347794bc49406825e1e506363
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spelling	oai:doaj.org-article:a32f817347794bc49406825e1e5063632021-12-02T15:09:04ZChanges in total homocysteine levels after acute stroke and recurrence of stroke10.1038/s41598-018-25398-52045-2322https://doaj.org/article/a32f817347794bc49406825e1e5063632018-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-018-25398-5https://doaj.org/toc/2045-2322Abstract It is not known how total homocysteine (tHcy) levels change during the transition from acute stroke to post-stroke convalescence or whether tHcy changes occurring after the acute period are associated with recurrence of cerebro-cardiovascular events. Levels of tHcy were measured during acute ischemia and again after three months. Patients were followed for a median of 18 (range: 12–36) months. A total of 2800 patients who had at least two tHcy measurements were enrolled between February 2012 and June 2014; 2587 patients presented with ischemic stroke and 213 presented with cerebral hemorrhage. During the follow-up period, 220 (7.9%) patients experienced another ischemic event. After adjusting for additional cardiovascular risk factors, patients with the highest levels of tHcy (fourth quartile; >15.5 μmol/L) had a 1.76-fold increased risk of a recurrence (adjusted HR: 1.76, 95%CI: 1.11–3.08) as compared to patients with the lowest levels of tHcy (lowest quartile; ≤9.65 μmol/L). Additional analysis by subgroup indicated that this correlation was only significant for patients with large-artery atherosclerosis ischemia (adjusted HR: 2.00, 95%CI: 1.13–3.55). Elevated tHcy during the convalescent phase of acute stroke was independently associated with an increased risk of recurrent ischemic stroke, especially in those patients with large-vessel atherosclerosis ischemia.Zhihong ShiShuling LiuYalin GuanMeilin ZhangHui LuWei YueBiao ZhangMingzi LiJing XueYong JiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 8, Iss 1, Pp 1-6 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Zhihong Shi Shuling Liu Yalin Guan Meilin Zhang Hui Lu Wei Yue Biao Zhang Mingzi Li Jing Xue Yong Ji Changes in total homocysteine levels after acute stroke and recurrence of stroke
description	Abstract It is not known how total homocysteine (tHcy) levels change during the transition from acute stroke to post-stroke convalescence or whether tHcy changes occurring after the acute period are associated with recurrence of cerebro-cardiovascular events. Levels of tHcy were measured during acute ischemia and again after three months. Patients were followed for a median of 18 (range: 12–36) months. A total of 2800 patients who had at least two tHcy measurements were enrolled between February 2012 and June 2014; 2587 patients presented with ischemic stroke and 213 presented with cerebral hemorrhage. During the follow-up period, 220 (7.9%) patients experienced another ischemic event. After adjusting for additional cardiovascular risk factors, patients with the highest levels of tHcy (fourth quartile; >15.5 μmol/L) had a 1.76-fold increased risk of a recurrence (adjusted HR: 1.76, 95%CI: 1.11–3.08) as compared to patients with the lowest levels of tHcy (lowest quartile; ≤9.65 μmol/L). Additional analysis by subgroup indicated that this correlation was only significant for patients with large-artery atherosclerosis ischemia (adjusted HR: 2.00, 95%CI: 1.13–3.55). Elevated tHcy during the convalescent phase of acute stroke was independently associated with an increased risk of recurrent ischemic stroke, especially in those patients with large-vessel atherosclerosis ischemia.
format	article
author	Zhihong Shi Shuling Liu Yalin Guan Meilin Zhang Hui Lu Wei Yue Biao Zhang Mingzi Li Jing Xue Yong Ji
author_facet	Zhihong Shi Shuling Liu Yalin Guan Meilin Zhang Hui Lu Wei Yue Biao Zhang Mingzi Li Jing Xue Yong Ji
author_sort	Zhihong Shi
title	Changes in total homocysteine levels after acute stroke and recurrence of stroke
title_short	Changes in total homocysteine levels after acute stroke and recurrence of stroke
title_full	Changes in total homocysteine levels after acute stroke and recurrence of stroke
title_fullStr	Changes in total homocysteine levels after acute stroke and recurrence of stroke
title_full_unstemmed	Changes in total homocysteine levels after acute stroke and recurrence of stroke
title_sort	changes in total homocysteine levels after acute stroke and recurrence of stroke
publisher	Nature Portfolio
publishDate	2018
url	https://doaj.org/article/a32f817347794bc49406825e1e506363
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Changes in total homocysteine levels after acute stroke and recurrence of stroke

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