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.
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Authors | Zhihong Shi, Shuling Liu, Yalin Guan, Meilin Zhang, Hui Lu, Wei Yue, Biao Zhang, Mingzi Li, Jing Xue, Yong Ji |
Journal | Scientific reports
(Sci Rep)
Vol. 8
Issue 1
Pg. 6993
(05 03 2018)
ISSN: 2045-2322 [Electronic] England |
PMID | 29725064
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Aged
- Female
- Follow-Up Studies
- Homocysteine
(blood)
- Humans
- Male
- Middle Aged
- Recurrence
- Risk Assessment
- Stroke
(epidemiology, pathology)
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