PMID- 36893016
OWN - NLM
STAT- MEDLINE
DCOM- 20230505
LR  - 20230505
IS  - 1743-1328 (Electronic)
IS  - 0161-6412 (Linking)
VI  - 45
IP  - 6
DP  - 2023 Jun
TI  - Elevated levels of total homocysteine after ischemic stroke: a potential marker 
      for in-hospital outcomes.
PG  - 497-504
LID - 10.1080/01616412.2022.2159137 [doi]
AB  - OBJECTIVES: Our goal was to determine the risk conferred by elevated total 
      homocysteine (tHcy) levels on recurrent stroke and cardiovascular disease (CVD) 
      events after an ischemic stroke (IS), using data from the Chinese Stroke Center 
      Alliance (CSCA). METHODS: The study consisted of 746,854 total participants with 
      IS. Subjects were split into groups as well as quartiles according to tHcy level. 
      Groups included a hyperhomocysteinemia (HHcy) group with tHcy >/=15 mumol/l and a 
      normohomocysteinemia group (nHcy) with tHcy <15 mumol/l. The determined groups and 
      quartiles underwent multiple logistic regression models with nHcy or quartile 1 
      as reference groups, respectively. The information from these analyses was 
      adjusted for potential covariates and used to investigate the association between 
      blood tHcy and in-hospital outcomes. Information collected at discharge included 
      in-hospital stroke recurrence and CVD events. RESULTS: The mean [SD] age of 
      participants was 66.2 [12.0] and 37.4% (n = 279,571) were female. The median 
      hospital duration was 11.0 days (interquartile range, 8.0-14.0 days) and 343,346 
      (46.0%) patients were identified as HHcy cases (tHcy >/=15 mumol/). According to the 
      tHcy quartile, the cumulative rates of stroke recurrence (from lowest quartile to 
      highest) were 5.2%, 5.6%, 6.1%, and 6.6% (P < 0.0001). Similarly, those of CVD 
      events were 5.8%, 6.1%, 6.7%, and 7.2% (P < 0.0001). Compared with the nHcy 
      group, the HHcy group was associated with increased risks of in-hospital stroke 
      recurrence (21912 [6.4%] vs. 22048 [5.5%], with the adjusted odds ratio (OR) 
      1.08, 95% CI: 1.05 to 1.10) as well as CVD events (24001 [7.0%] vs. 24236 [6.0%], 
      with the adjusted OR: 1.08, 95% CI: 1.06 to 1.10) among patients with IS in the 
      fully adjusted model. CONCLUSION: HHcy was associated with increased in-hospital 
      stroke recurrence and CVD events among patients with IS. In low-folate regions, 
      tHcy levels may potentially predict in-hospital outcomes after IS.
FAU - Liu, Wei
AU  - Liu W
AD  - China National Clinical Research Center for Neurological Diseases, Beijing 
      Tiantan Hospital, Capital Medical University, Beijing, China.
FAU - Ma, Xue-Lian
AU  - Ma XL
AD  - Department of Obstetrics and Gynecology, Beijing Tiantan Hospital, Capital 
      Medical University, Beijing, China.
FAU - Gu, Hong-Qiu
AU  - Gu HQ
AD  - China National Clinical Research Center for Neurological Diseases, Beijing 
      Tiantan Hospital, Capital Medical University, Beijing, China.
AD  - National Center for Healthcare Quality Management in Neurological Diseases, 
      Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
FAU - Li, Hao
AU  - Li H
AD  - China National Clinical Research Center for Neurological Diseases, Beijing 
      Tiantan Hospital, Capital Medical University, Beijing, China.
FAU - Li, Zi-Xiao
AU  - Li ZX
AD  - China National Clinical Research Center for Neurological Diseases, Beijing 
      Tiantan Hospital, Capital Medical University, Beijing, China.
AD  - National Center for Healthcare Quality Management in Neurological Diseases, 
      Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
AD  - Department of Neurology, Beijing Tiantan Hospital, Beijing, China.
FAU - Wang, Yong-Jun
AU  - Wang YJ
AD  - China National Clinical Research Center for Neurological Diseases, Beijing 
      Tiantan Hospital, Capital Medical University, Beijing, China.
AD  - National Center for Healthcare Quality Management in Neurological Diseases, 
      Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
AD  - Department of Neurology, Beijing Tiantan Hospital, Beijing, China.
LA  - eng
PT  - Journal Article
DEP - 20230309
PL  - England
TA  - Neurol Res
JT  - Neurological research
JID - 7905298
RN  - 0LVT1QZ0BA (Homocysteine)
SB  - IM
MH  - Humans
MH  - Female
MH  - Male
MH  - *Ischemic Stroke
MH  - *Stroke/epidemiology
MH  - *Cardiovascular Diseases
MH  - Logistic Models
MH  - Homocysteine
MH  - Risk Factors
OTO - NOTNLM
OT  - Cardiovascular disease (CVD)
OT  - hyperhomocysteinemia
OT  - multiple logistic regression analyses
OT  - normohomocysteinemia
OT  - the Chinese stroke center alliance (CSCA)
EDAT- 2023/03/10 06:00
MHDA- 2023/05/05 06:42
CRDT- 2023/03/09 12:52
PHST- 2023/05/05 06:42 [medline]
PHST- 2023/03/10 06:00 [pubmed]
PHST- 2023/03/09 12:52 [entrez]
AID - 10.1080/01616412.2022.2159137 [doi]
PST - ppublish
SO  - Neurol Res. 2023 Jun;45(6):497-504. doi: 10.1080/01616412.2022.2159137. Epub 2023 
      Mar 9.