PMID- 31249548
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 1664-2295 (Print)
IS  - 1664-2295 (Electronic)
IS  - 1664-2295 (Linking)
VI  - 10
DP  - 2019
TI  - Effect of Hyperhomocysteinemia on Clinical Outcome and Hemorrhagic Transformation 
      After Thrombolysis in Ischemic Stroke Patients.
PG  - 592
LID - 10.3389/fneur.2019.00592 [doi]
LID - 592
AB  - Background and Purpose: Hyperhomocysteinemia (Hhcy) is a well-known risk factor 
      for ischemic stroke. However, the role of Hhcy in the clinical outcome of 
      ischemic stroke has not been fully elucidated. In addition, previous studies have 
      found that Hhcy was implicated in the disruption of the blood-brain barrier, 
      which may increase the risk of hemorrhagic transformation (HT) after 
      thrombolysis. Thus, the aim of this study was to investigate the effect of Hhcy 
      on the clinical outcome and HT after thrombolysis in ischemic stroke patients. 
      Methods: Patients who were diagnosed with ischemic stroke and received 
      intravenous thrombolytic therapy between January 2016 and September 2018 were 
      included in this study. Multivariate logistic regression analysis was used to 
      assess the association between Hhcy, clinical outcome, and HT after thrombolysis. 
      Furthermore, the potential interaction between Hhcy and hypertension on the 
      clinical outcome and HT after thrombolysis was also assessed. Results: Of 568 
      patients, 455 (80.1%) had Hhcy, 66 (11.6%) had HT, and 219 (38.6%) had poor 
      outcome. Patients with Hhcy had a higher incidence of poor outcome than the 
      patients with non-Hhcy (40.9 vs. 29.2%, p = 0.022). However, there was no 
      significant difference in the incidence of HT (11.9 vs. 10.6%, p = 0.711) between 
      patients with Hhcy and non-Hhcy. After adjustment for major covariates, 
      multivariate logistic regression analysis disclosed that Hhcy was independently 
      associated with increased risk of poor outcome (OR = 1.760; 95% CI: 1.069-2.896) 
      but was not associated with the risk of HT (OR = 1.017; 95% CI: 0.495-2.087). In 
      addition, we found no significant interaction between Hhcy and hypertension on 
      the clinical outcome (p = 0.513) or HT (p = 0.170) after thrombolysis. 
      Conclusion: We found that Hhcy was an independent risk factor for poor outcome, 
      but not an independent risk factor for HT after thrombolysis in ischemic stroke 
      patients. In addition, there was no significant interaction of Hhcy and 
      hypertension on the clinical outcome or HT after thrombolysis.
FAU - Luo, Yun
AU  - Luo Y
AD  - Department of Neurology, Stroke Center, The First Hospital of Jilin University, 
      Chang Chun, China.
FAU - Jin, Hang
AU  - Jin H
AD  - Department of Neurology, Stroke Center, The First Hospital of Jilin University, 
      Chang Chun, China.
FAU - Guo, Zhen-Ni
AU  - Guo ZN
AD  - Department of Neurology, Neuroscience Center, The First Hospital of Jilin 
      University, Chang Chun, China.
FAU - Zhang, Peng
AU  - Zhang P
AD  - Department of Neurology, Stroke Center, The First Hospital of Jilin University, 
      Chang Chun, China.
FAU - Zhang, Li-Yue
AU  - Zhang LY
AD  - Department of Neurology, Stroke Center, The First Hospital of Jilin University, 
      Chang Chun, China.
FAU - Chen, Jie
AU  - Chen J
AD  - Department of Neurology, Stroke Center, The First Hospital of Jilin University, 
      Chang Chun, China.
FAU - Yu, Yao
AU  - Yu Y
AD  - Department of Neurology, Stroke Center, The First Hospital of Jilin University, 
      Chang Chun, China.
FAU - Wang, Yan
AU  - Wang Y
AD  - Department of Neurology, Stroke Center, The First Hospital of Jilin University, 
      Chang Chun, China.
FAU - Liu, Jie
AU  - Liu J
AD  - Department of Neurology, Stroke Center, The First Hospital of Jilin University, 
      Chang Chun, China.
FAU - He, Qian-Yan
AU  - He QY
AD  - Department of Neurology, Stroke Center, The First Hospital of Jilin University, 
      Chang Chun, China.
FAU - Sun, Xin
AU  - Sun X
AD  - Department of Neurology, Stroke Center, The First Hospital of Jilin University, 
      Chang Chun, China.
FAU - Yang, Yi
AU  - Yang Y
AD  - Department of Neurology, Stroke Center, The First Hospital of Jilin University, 
      Chang Chun, China.
LA  - eng
PT  - Journal Article
DEP - 20190604
PL  - Switzerland
TA  - Front Neurol
JT  - Frontiers in neurology
JID - 101546899
PMC - PMC6584786
OTO - NOTNLM
OT  - clinical outcome
OT  - hemorrhagic transformation
OT  - hyperhomocysteinemia
OT  - intravenous thrombolysis
OT  - ischemic stroke
OT  - recombinant tissue plasminogen activator
OT  - symptomatic intracerebral hemorrhage
EDAT- 2019/06/30 06:00
MHDA- 2019/06/30 06:01
PMCR- 2019/06/04
CRDT- 2019/06/29 06:00
PHST- 2019/03/15 00:00 [received]
PHST- 2019/05/20 00:00 [accepted]
PHST- 2019/06/29 06:00 [entrez]
PHST- 2019/06/30 06:00 [pubmed]
PHST- 2019/06/30 06:01 [medline]
PHST- 2019/06/04 00:00 [pmc-release]
AID - 10.3389/fneur.2019.00592 [doi]
PST - epublish
SO  - Front Neurol. 2019 Jun 4;10:592. doi: 10.3389/fneur.2019.00592. eCollection 2019.