Serum Homocysteine and the Short-Term Outcome of Ischemic Stroke

Abstract

Background: Homocysteine is considered as one of the factors affecting the prognosis of ischemic stroke. The aim of this study is to determine the relationship between homocysteine level and ischemic stroke outcome.

Method: This cross-sectional study was conducted between December 2010 and September 2011 on 145 patients with ischemic stroke in middle cerebral artery (MCA) territory, after approval by Guilan University of Medical Science’s Ethics Committee. Patients with a history of stroke, brain lesion, liver or kidney disorders, pneumonia, sepsis and who had seizure at the beginning or during hospitalization were excluded. Uncontrolled diabetes, anemia and dramatic blood pressure reduction in admission were defined as confounding factors. In the first week, serum level of homocysteine was measured and the functional independence and status of patients were measured with functional independence measure (FIM) and Barthel index (BI) in the first week and first month after stroke. Data were analyzed by t-test, ANOVA, Mann-Whitney U, Kruskal-Wallis tests and backward stepwise logistic and linear regression analysis using SPSS 19.

Results: One hundred and forty-five patients (55.9% men and 44.1% women) with mean age of 68.3 ± 13.8 years old were evaluated. Serum level of homocysteine was determined as an independent predictor for mortality in the first week (P = 0.017; OR = 1.179; 95% CI: 1.03 - 1.35). No significant correlation was found between serum homocysteine level and BI and FIM in the period of study (P > 0.05).

Conclusions: Homocysteine decreases mortality rate in patients with stroke in the first week but does not affect the functional outcome of alive patients.




J Neurol Res. 2014;4(1):15-21
doi: http://dx.doi.org/10.14740/jnr265w