PMID- 27629768
OWN - NLM
STAT- MEDLINE
DCOM- 20170504
LR  - 20190606
IS  - 1643-3750 (Electronic)
IS  - 1234-1010 (Print)
IS  - 1234-1010 (Linking)
VI  - 22
DP  - 2016 Sep 15
TI  - Elevated Homocysteine Level Related to Poor Outcome After Thrombolysis in Acute 
      Ischemic Stroke.
PG  - 3268-73
AB  - BACKGROUND Hyperhomocysteinemia (HHcy) is a well-known risk factor for ischemic 
      stroke. However, whether HHcy can influence the treatment outcome of acute 
      ischemic stroke (AIS) patients has yet to be fully determined. In this study, we 
      investigated the relationship between serum homocysteine (Hcy) level and 
      prognosis in AIS patients who received tissue plasminogen activator (tPA) 
      treatment. MATERIAL AND METHODS Patients were recruited according to the research 
      criteria and grouped by their serum Hcy levels. Neurological outcome was 
      evaluated by National Institute of Health Stroke Scale (NIHSS) score system 
      before and 1 week after treatment, and functional outcome was evaluated by 
      modified Rankin Scale (MRS) score system after 3 months. All patients took CT/MRI 
      examination to detect cerebral hemorrhage in 24 hours after tPA treatment. 
      Receiver operating characteristic curve (ROC) was employed to assess if serum 
      homocysteine level can be used as an index to predict the outcome after tPA 
      treatment. RESULTS The mean (+/-SD) serum Hcy level of 194 patients was 22.62+/-21.23 
      mumol/L. After 1-week tPA treatment, the NIHSS scores of high Hcy level group were 
      significantly higher than those of low level group (p<0.05), meantime the high 
      Hcy group showed obvious symptomatic intracerebral hemorrhage risk after 24 hours 
      (p<0.05). Poor outcome was presented in mRS score results after 3 months in high 
      Hcy level group, which compared with low Hcy level group (p<0.01). The ROC showed 
      that Hcy level was a moderately sensitive and specific index to predict the 
      prognosis with an optimal cut-off value at 19.95 micromol/L (sensitivity [58.2%], 
      specificity [80.3%]). CONCLUSIONS High serum homocysteine level could potentially 
      predict poor prognosis in acute ischemic stroke patients after tPA treatment.
FAU - Yao, En-Sheng
AU  - Yao ES
AD  - Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong 
      University of Science and Technology, Wuhan, Hubei, China (mainland).
FAU - Tang, Yan
AU  - Tang Y
AD  - Department of Geriatric, First Affiliated Hospital, School of Medicine, Shihezi 
      University, Shihezi, Xinjiang, China (mainland).
FAU - Xie, Min-Jie
AU  - Xie MJ
AD  - Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong 
      University of Science and Technology, Wuhan, Hubei, China (mainland).
FAU - Wang, Ming-Huan
AU  - Wang MH
AD  - Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong 
      University of Science and Technology, Wuhan, Hubei, China (mainland).
FAU - Wang, Hong
AU  - Wang H
AD  - Department of Neurology, First Affiliated Hospital, School of Medicine, Shihezi 
      University, Shihezi, Xinjiang, China (mainland).
FAU - Luo, Xiang
AU  - Luo X
AD  - Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong 
      University of Science and Technology, Wuhan, Hubei, China (mainland).
LA  - eng
PT  - Journal Article
DEP - 20160915
PL  - United States
TA  - Med Sci Monit
JT  - Medical science monitor : international medical journal of experimental and 
      clinical research
JID - 9609063
RN  - 0LVT1QZ0BA (Homocysteine)
RN  - EC 3.4.21.68 (Tissue Plasminogen Activator)
SB  - IM
MH  - Aged
MH  - Cohort Studies
MH  - Female
MH  - Homocysteine/*blood
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Stroke/*blood/diagnostic imaging/*drug therapy
MH  - Thrombolytic Therapy/methods
MH  - Tissue Plasminogen Activator/therapeutic use
MH  - Treatment Outcome
PMC - PMC5034885
EDAT- 2016/09/16 06:00
MHDA- 2017/05/05 06:00
PMCR- 2016/09/15
CRDT- 2016/09/16 06:00
PHST- 2016/09/16 06:00 [entrez]
PHST- 2016/09/16 06:00 [pubmed]
PHST- 2017/05/05 06:00 [medline]
PHST- 2016/09/15 00:00 [pmc-release]
AID - 900010 [pii]
AID - 10.12659/msm.900010 [doi]
PST - epublish
SO  - Med Sci Monit. 2016 Sep 15;22:3268-73. doi: 10.12659/msm.900010.