Relationship between homocysteine levels and post-stroke cognitive impairment in female and male population: from a prospective multicenter study

Abstract

Background and Objectives: To investigate the relationship between homocysteine levels and post-stroke cognitive impairment (PSCI) in Chinese female and male populations with minor acute ischemic stroke or transient ischemic attack. Materials and methods: A total of 1070 participants with clinically confirmed acute minor ischemic stroke or transient ischemic attack and baseline homocysteine information from a nationwide multicenter prospective registry study in China were included in this study. Of these, 919 patients had cognitive assessments at 3-month follow-ups and 584 participants had cognitive assessments at 12-month follow-ups. The incidence of PSCI was defined as a Montreal Cognitive Assessment score ≤22. The differences in homocysteine levels and the incidence of PSCI were compared between female and male populations. Relationships between homocysteine levels and the incidence of PSCI in female and male populations were analyzed using multiple logistic regression, respectively. Results: Females had lower baseline homocysteine levels than males. Compared to males, females had lower education levels, lower rates of smoking and alcohol intake, and higher rates of diabetes and hypertension. No relationship was observed between elevated homocysteine level and 3-month PSCI incidence in either females or males. After adjusting the confounders, elevated baseline homocysteine significantly increased the 12-month PSCI risk (odds ratio 3.28, 95% confidence interval 1.47–7.34, P = 0.004) in females, but not in males (odds ratio 0.86, 95% confidence interval 0.49–1.49, P = 0.586). Conclusion: Elevated homocysteine levels increased the 12-month PSCI risk in females, but not in males with minor acute ischemic stroke or transient ischemic attack.

Resourcefulness Among Initial Ischemic Stroke Patients: A Longitudinal Study of 12 Months

“…In society, robust social support provides individuals with additional resources and encourages the adoption of coping strategies. In particular, although homocysteine was not shown to be a meaningful predictor in regression analysis, a prospective study 47 found that elevated homocysteine levels were independently positively associated with depression or vascular dementia in women with mild acute ischemic stroke or TIA. Thus, future research should examine homocysteine levels as biochemical biomarkers for indicating a risk for low resourcefulness.…”

The Association of Plasma Homocysteine Concentrations with a 10-Year Risk of All-Cause and Cardiovascular Mortality in a Community-Based Chinese Population

“…In brief, multiple molecular mechanisms underlying Hcy may contribute to the occurrence and development of CVD, including damaging vascular endothelial cells, promoting vascular smooth muscle cell proliferation and migration, and activating excessive oxidative stress reactions, lipid metabolism disorders, and coagulation dysfunction [ 29 ]. Numerous studies have demonstrated that increased plasma Hcy may bring about cardio- and cerebrovascular diseases, neurological disorders, and even target organ damage [ 30 , 31 , 32 , 33 ]. This association between elevated Hcy levels and higher CV mortality was similar in both Korean [ 24 ] and Japanese [ 34 ] general populations, which confirms that the association between them is robust and consistent in East Asian populations.…”

Safety and efficacy of arterial injection of tirofiban in treating ischemic stroke beyond the window period

“…Clinical studies have shown that there is an early risk of re-occlusion in patients with large-vessel occlusion stroke associated with intracranial atherosclerotic stenosis [18]. Intravenous injection of tirofiban reduces the rate of early reocclusion without increasing the risk of substantial hemorrhage, symptomatic bleeding, 90-day favorable outcomes, or death rate [19].…”