PMID- 36514491
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221221
IS  - 1176-6328 (Print)
IS  - 1178-2021 (Electronic)
IS  - 1176-6328 (Linking)
VI  - 18
DP  - 2022
TI  - Homocysteine and Clinical Outcomes in Intracerebral Hemorrhage Patients: Results 
      from the China Stroke Center Alliance.
PG  - 2837-2846
LID - 10.2147/NDT.S391618 [doi]
AB  - OBJECTIVE: Elevated homocysteine (Hcy) levels play a detrimental role in ischemic 
      stroke. Acute spontaneous intracerebral hemorrhage (ICH) accounts for nearly 25% 
      of all stroke cases. However, the influence of Hcy levels and ICH severity on 
      clinical outcomes is unclear. PARTICIPANTS AND STUDY LOCATION: Data were obtained 
      from 85,705 ICH patients enrolled in the China Stroke Center Alliance (CSCA) 
      study, a national, hospital-based, multicenter, voluntary, quality assessment and 
      improvement initiative performed in China. Patients were divided into high and 
      normal Hcy groups according to their Hcy levels observed at admission. OUTCOME 
      MEASURES: The outcome indices included severe ICH, in-hospital mortality, and a 
      poor functional outcome at discharge. Multivariable logistic regression was used 
      to analyze the association of different Hcy levels with outcomes. RESULTS: The 
      final analysis included 55,793 ICH patients. High homocysteine (HHcy) levels had 
      higher adjusted odds ratios for severe ICH (OR 1.09, 95% CI 1.01-1.10, P<0.0001) 
      and a poor functional outcome at discharge (OR 1.06, 95% CI 1.01-1.10, P=0.0100) 
      compared with normal Hcy levels. There was no significant difference between HHcy 
      and in-hospital mortality. In the subgroup analysis, stratified by sex and 
      history of hypertension, significant interactions were observed between HHcy and 
      severe ICH (P for interactions was 0.0138 and 0.0120, respectively). HHcy levels 
      exhibited greater associations for severe ICH in female patients (OR 1.07, 95% CI 
      1.02-1.12) and patients without hypertension (OR 1.20, 95% CI 1.09-1.33). 
      CONCLUSION: An elevated Hcy level exhibited significant association with severe 
      ICH on admission and a poor functional outcome at discharge. The relationship 
      between HHcy and ICH severity on admission was more robust in female patients and 
      patients without hypertension. Hcy might be a valuable biomarker for ICH patients 
      to predict severity at onset and functional outcome at discharge.
CI  - (c) 2022 Wang et al.
FAU - Wang, Dandan
AU  - Wang D
AUID- ORCID: 0000-0001-6836-0705
AD  - Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, 
      Beijing, People's Republic of China.
AD  - China National Clinical Research Center for Neurological Diseases, Beijing, 
      People's Republic of China.
FAU - Cao, Zhentang
AU  - Cao Z
AD  - Department of Neurology, The First Affiliated Hospital of Zhengzhou University, 
      Zhengzhou, Henan, People's Republic of China.
FAU - Li, Zixiao
AU  - Li Z
AD  - Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, 
      Beijing, People's Republic of China.
AD  - China National Clinical Research Center for Neurological Diseases, Beijing, 
      People's Republic of China.
AD  - Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese 
      Academy of Medical Sciences, Beijing, People's Republic of China.
FAU - Gu, Hongqiu
AU  - Gu H
AD  - China National Clinical Research Center for Neurological Diseases, Beijing, 
      People's Republic of China.
FAU - Zhou, Qi
AU  - Zhou Q
AD  - China National Clinical Research Center for Neurological Diseases, Beijing, 
      People's Republic of China.
FAU - Zhao, Xingquan
AU  - Zhao X
AUID- ORCID: 0000-0001-8345-5147
AD  - Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, 
      Beijing, People's Republic of China.
AD  - China National Clinical Research Center for Neurological Diseases, Beijing, 
      People's Republic of China.
AD  - Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese 
      Academy of Medical Sciences, Beijing, People's Republic of China.
FAU - Wang, Yongjun
AU  - Wang Y
AD  - Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, 
      Beijing, People's Republic of China.
AD  - China National Clinical Research Center for Neurological Diseases, Beijing, 
      People's Republic of China.
AD  - Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese 
      Academy of Medical Sciences, Beijing, People's Republic of China.
LA  - eng
PT  - Journal Article
DEP - 20221207
PL  - New Zealand
TA  - Neuropsychiatr Dis Treat
JT  - Neuropsychiatric disease and treatment
JID - 101240304
PMC - PMC9741835
OTO - NOTNLM
OT  - homocysteine
OT  - intracerebral hemorrhage
OT  - outcome
OT  - stroke severity
COIS- There is no financial or non-financial conflict of interest in our study.
EDAT- 2022/12/15 06:00
MHDA- 2022/12/15 06:01
PMCR- 2022/12/07
CRDT- 2022/12/14 01:57
PHST- 2022/09/28 00:00 [received]
PHST- 2022/11/25 00:00 [accepted]
PHST- 2022/12/14 01:57 [entrez]
PHST- 2022/12/15 06:00 [pubmed]
PHST- 2022/12/15 06:01 [medline]
PHST- 2022/12/07 00:00 [pmc-release]
AID - 391618 [pii]
AID - 10.2147/NDT.S391618 [doi]
PST - epublish
SO  - Neuropsychiatr Dis Treat. 2022 Dec 7;18:2837-2846. doi: 10.2147/NDT.S391618. 
      eCollection 2022.