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Homocysteine as a predictor of early neurological deterioration in acute ischemic stroke.
- Source :
-
Stroke [Stroke] 2014 Mar; Vol. 45 (3), pp. 871-3. Date of Electronic Publication: 2014 Jan 21. - Publication Year :
- 2014
-
Abstract
- Background and Purpose: Hyperhomocysteinemia is a well-known risk factor for vascular disease. However, its action, mechanism, and role in the acute phase of stroke have not been determined. We tried to determine whether an association existed between elevated serum homocysteine levels and early neurological deterioration (END) in patients with acute ischemic stroke.<br />Methods: We performed a secondary analysis from the Cilostazol in Acute Ischemic Stroke Treatment (CAIST) trial, which was a double-blinded, randomized, multicenter trial, assessing the noninferiority of cilostazol over aspirin within 48 hours of an acute ischemic stroke. END was defined as an increase of ≥1 point in motor power or an increase of ≥2 points in the total National Institute of Health Stroke Scale score within 7 days.<br />Results: The mean (±SD) serum homocysteine level was 11.4±4.7 μmol/L. Of the 396 patients studied, 57 (14.4%) patients worsened during the 7 days after inclusion. Most (68%) of the END cases occurred within the first 24 hours after treatment. High levels (>10.3 μmol/L) of serum homocysteine were independent predictors for END (third quartile odds ratio, 3.45; 95% confidence intervals, 1.25-9.50; P=0.016; fourth quartile odds ratio, 3.36; 95% confidence intervals 1.18-9.52; P=0.023) in multivariate analysis.<br />Conclusions: Patients with acute stroke with elevated serum homocysteine levels are at an increased risk for END.
- Subjects :
- Aged
Aspirin therapeutic use
Biomarkers blood
C-Reactive Protein analysis
Cilostazol
Disease Progression
Double-Blind Method
Female
Glycated Hemoglobin analysis
Humans
Hyperhomocysteinemia blood
Male
Middle Aged
Platelet Aggregation Inhibitors therapeutic use
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Prospective Studies
Risk Factors
Tetrazoles therapeutic use
Brain Ischemia pathology
Homocystine blood
Nervous System pathology
Stroke pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1524-4628
- Volume :
- 45
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Stroke
- Publication Type :
- Academic Journal
- Accession number :
- 24448992
- Full Text :
- https://doi.org/10.1161/STROKEAHA.113.004099