PMID- 27260368
OWN - NLM
STAT- MEDLINE
DCOM- 20170406
LR  - 20170406
IS  - 1532-8511 (Electronic)
IS  - 1052-3057 (Linking)
VI  - 25
IP  - 8
DP  - 2016 Aug
TI  - Association of Hyperhomocysteinemia with Stroke Recurrence after Initial Stroke.
PG  - 2047-54
LID - S1052-3057(16)30063-5 [pii]
LID - 10.1016/j.jstrokecerebrovasdis.2016.05.008 [doi]
AB  - 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.
CI  - Copyright (c) 2016 National Stroke Association. Published by Elsevier Inc. All 
      rights reserved.
FAU - Kumral, Emre
AU  - Kumral E
AD  - Stroke Unit, Neurology Department, School of Medicine, Ege University, Izmir, 
      Turkey. Electronic address: emre.kumral@ege.edu.tr.
FAU - Saruhan, Gulsum
AU  - Saruhan G
AD  - Stroke Unit, Neurology Department, School of Medicine, Ege University, Izmir, 
      Turkey.
FAU - Aktert, Dilara
AU  - Aktert D
AD  - Stroke Unit, Neurology Department, School of Medicine, Ege University, Izmir, 
      Turkey.
FAU - Orman, Mehmet
AU  - Orman M
AD  - Biostatistic Department, School of Medicine, Ege University, Izmir, Turkey.
LA  - eng
PT  - Journal Article
DEP - 20160531
PL  - United States
TA  - J Stroke Cerebrovasc Dis
JT  - Journal of stroke and cerebrovascular diseases : the official journal of National 
      Stroke Association
JID - 9111633
RN  - 12001-76-2 (Vitamin B Complex)
RN  - 462-10-2 (Homocystine)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Electrocardiography
MH  - Female
MH  - Homocystine/blood
MH  - Humans
MH  - Hyperhomocysteinemia/*complications/diagnostic imaging/*epidemiology
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Neuroimaging
MH  - Proportional Hazards Models
MH  - Recurrence
MH  - Risk Factors
MH  - Statistics, Nonparametric
MH  - Stroke/blood/*complications/diagnostic imaging/*epidemiology
MH  - Survival Analysis
MH  - Vitamin B Complex/therapeutic use
OTO - NOTNLM
OT  - Homocysteine
OT  - large-artery disease
OT  - small-artery disease
OT  - stroke recurrence
EDAT- 2016/06/05 06:00
MHDA- 2017/04/07 06:00
CRDT- 2016/06/05 06:00
PHST- 2016/04/18 00:00 [received]
PHST- 2016/05/06 00:00 [revised]
PHST- 2016/05/08 00:00 [accepted]
PHST- 2016/06/05 06:00 [entrez]
PHST- 2016/06/05 06:00 [pubmed]
PHST- 2017/04/07 06:00 [medline]
AID - S1052-3057(16)30063-5 [pii]
AID - 10.1016/j.jstrokecerebrovasdis.2016.05.008 [doi]
PST - ppublish
SO  - J Stroke Cerebrovasc Dis. 2016 Aug;25(8):2047-54. doi: 
      10.1016/j.jstrokecerebrovasdis.2016.05.008. Epub 2016 May 31.