Relationship Between Homocysteine and Ischemic Stroke

Rahman, Aminur; Gupta, Ratan Das; Quraishi, Firoz Ahmed; Saha, Uttam Kumar; Miah, Nurul Amin; Ali, Zahed

doi:10.3329/bjmed.v25i1.25071

Cited by 5 publications

(5 citation statements)

References 15 publications

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“…Only articles rated good are reported on and discussed in this article. Studies rated fair 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 and poor 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95…”

Section: Resultsmentioning

confidence: 99%

“…Five studies showed an association between small-and large-vessel diseases when subclassifying stroke using the 71 Kelly et al ( 2004) 31 Alkali et al (2006) 131 Kim et al (2011) 32 Araki et al (1989) 72 Kim et al (2011) 33 Fekih-Mrissa et al (2013) 80 Kristensen et al (1999) 34 Ma et al (2017) 42 Lee et al ( 2008) 36 Sun et al ( 2005) 95 Li et al (2018) 38 Tas et al ( 2005) 96 Lu et al (2018) 40 Yi et al (2013) 101 Luo et al (2017) 41 Yingdong et al (2002) 102 Ma et al (2011) 43 Cross-sectional studies Mao and Han (2018) 44 Adunsky et al (2000) 69 Meiklejohn et al (2001) 45 Ben-Salem et al (2010) 73 Modi et al ( 2005) 47 Brattström et al (1992) 74 Moe et al ( 2008) 48 Cao et al (2019) 128 Mojiminiyi et al ( 2008) 49 Celikbilek et al (2014) 75 Pezzini et al (2002) 52 Cingozbay et al (2002) 76 Rahman et al (2013) 54 Coull et al (1990) 77 Tantirittisak et al (2007) 55 El Kossi and Zakhary (2000) 78 Vayá et al (2011) 57 Fatima et al (2012) 79 Yang et al (2004)…”

Section: Discussionmentioning

confidence: 99%

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Hyperhomocysteinemia and Ischemic Stroke: A Potential Dose-Response Association—A Systematic Review and Meta-analysis

Holmen

Hvas

Arendt

2021

TH Open

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Background and Purpose Previous studies suggest an association between increased homocysteine (Hcy) and risk of ischemic stroke. Yet, it remains unknown whether a dose-response association exists between Hcy levels and risk of ischemic stroke. Methods Systematic literature searches were performed in PubMed, Embase, Scopus, and Web of Science. Inclusion criteria were studies investigating ischemic stroke risk in an adult population with measured Hcy levels. We computed odds ratios (ORs) for a 5 µmol/L increase in Hcy levels using a random effects meta-analysis. Results In total, 108 studies met the inclusion criteria of which 22 were rated as high-quality studies, and 20 studies included a dose-response analysis. Hcy levels were analyzed either as a continuous or categorical variable. The majority of the studies found an increased risk of ischemic stroke when comparing the highest-to-lowest Hcy strata. A graded association was observed over the Hcy strata, indicating a dose-response association, with the most apparent effect when Hcy levels exceeded approximately 15 µmol/L. No studies explored a potential nonlinear association between Hcy levels and ischemic stroke. Six studies were included in a meta-analysis, showing an OR of 1.43 (95% confidence interval [CI]: 1.28–1.61) per 5 µmol/L increase in Hcy levels. Conclusion This review and meta-analysis indicate a dose-response association between Hcy levels and ischemic stroke. An evident increase in effect measures was observed when Hcy levels exceeded 15 µmol/L, indicating a nonlinear association between ischemic stroke and Hcy levels. This nonlinear association warrants further study.This study is registered with clinical trial ( https://www.crd.york.ac.uk/prospero/ ; unique identifier: CRD42019130371).

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hyperhomocysteinemia and Ischemic Stroke: A Potential Dose-Response Association—A Systematic Review and Meta-analysis

Holmen

Hvas

Arendt

2021

TH Open

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“…4,5 Hiperhomosisteinemia diketahui berkaitan dengan meningkatnya risiko kardiovaskular 6 dan serebrovaskular. 7 Sebuah meta-analisis studi observasional menyimpulkan bahwa setiap peningkatan 2,5 µmol/L total plasma homosistein meningkatkan risiko infark miokard 10% dan meningkatkan risiko stroke 20%. 8 Asam folat berperan dalam metabolisme ANALISIS homosistein melalui siklus remetilasi.…”

Section: Pendahuluanunclassified

Efikasi Suplementasi Asam Folat terhadap Kejadian Stroke pada Pasien Hiperhomosisteinemia dengan Riwayat Penyakit Jantung Koroner – Telaah Kasus Berbasis Bukti

Santoso

Haryadi

Rinaldi

2022

CDK

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Beberapa studi uji klinis yang meneliti efikasi asam folat untuk mencegah kejadian stroke pada pasien hiperhomosisteinemia dengan penyakit kardiovaskular memberikan simpulan yang inkonklusif. Tujuan laporan kasus berbasis bukti ini untuk menilai apakah suplementasi asam folat dapat menurunkan risiko stroke pada pasien dengan riwayat jantung koroner dengan hiperhomosisteinemia. Pencarian komprehensif melalui beberapa basis data online. Telaah kritis menggunakan alat penilaian dari Centre of Evidence Based Medicine (CEBM). Diperoleh dua studi kajian sistematik yang sesuai kriteria seleksi. Hasil telaah kritis mendapatkan bahwa kedua studi tersebut memiliki validitas baik. Analisis menunjukkan bahwa suplementasi asam folat dapat menurunkan kejadian stroke pada pasien dengan riwayat penyakit kardiovaskular.

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“…The studies show that hyperhomocysteinemia increases the chances of having a thromboembolic condition but it is still not clear which subtype of stroke is associated with hyperhomocysteinaemia [8]. In one of the studies, 75% of the ischemic stroke patients were found to have elevated fasting homocysteine levels [9] while in another study, 76.66% cases of ischemic stroke were revealed to have high fasting homocysteine levels as compared to normal people [10].…”

Section: Introductionmentioning

confidence: 99%

Homocysteine Levels in Acute Ischemic Stroke

Pathan

Lohano

Rind

et al. 2022

JPRI

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Objective: The objective of this study was to determine the frequency of elevated homocysteine levels in acute ischemic stroke patients presenting to the medical department, civil hospital, Nawabshah. Methodology: A cross-sectional study was conducted at the Department of Medicine Civil Hospital, Nawabshah from 13/02/2021 to 12/08/2021. It included ischemic stroke patients and evaluated their homocysteine levels (≥15µmol/L were elevated). Homocysteine levels was compared then in relation with the other sub-groups of patients based on the age group, gender and obesity, smoking, hypertensive and diabetic status, and hyperlipidemia. Results: There were 171 (64.5%) males and 94 (35.5%) females with mean age 49.9 ± 5.8 years Elevated levels of homocysteine were recorded in 140 (52.8%) patients with acute ischemic stroke. The frequency of elevated levels of homocysteine across various subgroups of patients in relation to age, gender, obesity, smoking, hypertension, diabetes, and hyperlipidemia was found to be insignificant. Conclusion: The findings of this study show patients with acute ischemic stroke had elevated levels of homocysteine which suggests potential implications of homocysteine level assessment in the diagnostic workup as well as risk stratification and management planning of patients with acute ischemic stroke presenting in future medical practice.

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Relationship Between Homocysteine and Ischemic Stroke

Abstract: Abstract

Cited by 5 publications

References 15 publications

Hyperhomocysteinemia and Ischemic Stroke: A Potential Dose-Response Association—A Systematic Review and Meta-analysis

Hyperhomocysteinemia and Ischemic Stroke: A Potential Dose-Response Association—A Systematic Review and Meta-analysis

Efikasi Suplementasi Asam Folat terhadap Kejadian Stroke pada Pasien Hiperhomosisteinemia dengan Riwayat Penyakit Jantung Koroner – Telaah Kasus Berbasis Bukti

Homocysteine Levels in Acute Ischemic Stroke

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