Abstract WP159: The Association Between Cerebral Artery Calcification and Homocysteine Among Stroke Patients

Introduction: Elevated serum homocysteine level is known to be associated with increased risk of atherosclerosis and cardiovascular event possibly through endothelial senescence. Also, homocysteine was reported to be a potential regulator of vascular calcification in animal study. Hypothesis: We hypothesized that elevated homocysteine level is associated with cerebral artery calcification. Methods: We identified 708 consecutive patients (mean age 66.3+/-12.9, 297 female patients) who were admitted with acute ischemic stroke or transient ischemic attack. Cerebral artery calcification was assessed from brain CT angiography, and advanced calcification was determined when calcification involved long (more than 1 cm) or thick (50% or more of vessel diameter) segment of distal cavernous internal carotid artery. Hyperhomocyseinemia was defined as serum homocysteine level exceeding 15 umol/L on admission. Results: Cerebral artery calcification from brain CT angiography was present in 546 patients (77.2%). Advanced cerebral artery calcification was detected in 156 patients (22.1%), and hyperhomocysteienemia was detected in 171 patients (24.2%). On bivariate analysis, advanced cerebral artery calcification was associated with hypertension, diabetes mellitus, smoking, atrial fibrillation, previous stroke history, high-sensitivity C-reactive protein (hs-CRP) and elevated homocysteine level. Multivariate logistic regression analysis including hyperhomocysteinemia, vascular risk factors, age>70 years and hsCRP>2.0mg/dL showed that hyperhomocysteinemia is independently associated with advanced cerebral artery calcification (odds ratio 1.8, confidence interval 1.1-2.8, p=0.011). Conclusion: Hyperhomocysteinemia was associated with advanced cerebral artery calcification. Our study suggests that homocysteine may be used as a biomarker for cerebral artery calcification.

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Raised Serum Homocysteine Level is Associated with Hypertension

Bangladesh Journal of Medical Biochemistry ◽

10.3329/bjmb.v11i1.39764 ◽

2019 ◽

Vol 11 (1) ◽

pp. 22-25

Author(s):

S Biswas ◽

R Haque ◽

N Uddin ◽

AR Saha ◽

K Sultan ◽

...

Keyword(s):

Homocysteine Level ◽

Elevated Serum ◽

Cross Sectional ◽

Homocysteine Concentration ◽

National Health Care ◽

Medical College ◽

Serum Homocysteine ◽

Increased Risk ◽

Clinical Measurements ◽

Group Serum

An elevated serum homocysteine concentration is associated with an increased risk of coronary, cerebral, and peripheral vascular disease. The objective of the study was to evaluate the association of serum homocysteine level with hypertension (HTN). This cross sectional analytical study was conducted at Sir Salimullah Medical College & Mitford Hospital and National Health Care Network Dhaka, Bangladesh over a duration of 21 months from July 2012 to May 2014. Fifty HTN patients were included as study subjects and age and sex matched fifty non-HTN healtlhy controls were included. All the clinical measurements were taken and serum Hcy was measured for all study subjects. In this study, females were predominant in both groups, mean age of the HTN patients was 41.0±5.6 years and non-HTN healthy subjects was 38.2±5.2 years. BMI and FBG were found higher in HTN group than that of non-HTN group but the differences were not statistically significant. Systolic and diastolic BP were found significantly higher in HTN group than that of non-HTN group. Serum Hcy level was significantly higher in HTN group (19.93±4.12 μmol/L) than that of non-HTN group (13.20±1.88 μmol/L). This study depicted that serum Hcy had significant correlation with SBP and DBP in HTN. In conclusion, it was seen that elevated serum Hcy level is associated with hytpertension. Bangladesh J Med Biochem 2018; 11(1): 22-25

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Association between Serum Urate and Risk of Hypertension in Menopausal Women with XDH Gene

Journal of Clinical Medicine ◽

10.3390/jcm8050738 ◽

2019 ◽

Vol 8 (5) ◽

pp. 738 ◽

Cited By ~ 3

Author(s):

Jong-Han Lee ◽

Tae Hwa Go ◽

San-Hui Lee ◽

Juwon Kim ◽

Ji Hye Huh ◽

...

Keyword(s):

Logistic Regression ◽

Confidence Interval ◽

Postmenopausal Women ◽

Elevated Serum ◽

Multivariate Logistic Regression Analysis ◽

Xanthine Dehydrogenase ◽

Serum Urate ◽

Increased Risk ◽

Dehydrogenase Gene ◽

Menopausal Women

Elevated serum urate (sUA) concentrations have been associated with an increased risk of hypertension. We aimed to examine the association of sUA concentration on the risk of hypertension in pre- and post-menopausal women and investigated the association between the polymorphism of the xanthine dehydrogenase gene and the risk of hypertension. Among 7294 women, 1415 premenopausal and 5879 postmenopausal women were recruited. Anthropometric parameters as risk factors of hypertension were identify by logistic regression models. In addition, we investigated an association between xanthine dehydrogenase gene and sUA and their combined associations on the risk of hypertension. Body mass index (BMI) and waist circumference (WC) were significantly increased in accordance to the increase of sUA levels (p < 0.001). Multivariate logistic regression analysis showed postmenopausal women with a high sUA and high BMI were 3.18 times more likely to have hypertension than in those with normal and lower sUA (Odds ratio: 3.18, 95% confidence interval: 2.54–3.96). Postmenopausal women with a high WC were 1.62 times more likely to have hypertension than in those with normal and lower sUA. Subjects with the AG genotype of rs206860 was found to be at lower risk of hypertension (odd ratio: 0.287, 95% confidence interval: 0.091–0.905, p = 0.033). This cross-sectional study indicated a high sUA is associated with a higher risk of hypertension in postmenopausal women. Further well-designed prospective studies in other populations are warranted to validate our results.

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Association of Serum Homocysteine and Serum Lipid with Eclampsia

Journal of Armed Forces Medical College Bangladesh ◽

10.3329/jafmc.v5i1.2842 ◽

1970 ◽

Vol 5 (1) ◽

pp. 7-10

Author(s):

Monzarin Mahal ◽

Farida Yeasmin ◽

Syed AKM Nurul Amin ◽

Afia Shahnaj ◽

Maliha Rashid ◽

...

Keyword(s):

Pregnant Women ◽

Lipid Profile ◽

Homocysteine Level ◽

Elevated Serum ◽

Hdl Cholesterol ◽

Significant Negative Correlation ◽

Cholesterol Concentration ◽

Mortality And Morbidity ◽

Serum Homocysteine ◽

Control Study

Eclampsia is one of the most common pregnancy complications causing high mortality and morbidity for both mother and foetus especially in developing countries. Many studies suggest that elevated homocysteine level is an important risk factor for eclampsia. The aim of this study was to explore the association between serum homocysteine with eclampsia and to establish serum homocysteine measurement as a reliable test for early detection of eclampsia. In a case control study serum homocysteine and lipid profile were measured in 52 controls (healthy uncomplicated pregnant women) and 50 eclamptic pregnant women. Serum homocysteine in eclampsia cases (10.44±4.08 μmol/L) found to be significantly increased (p < 0.001) compared to controls (7.97±3.46 μmol/L). Serum HDL-cholesterol concentration found to be significantly decreased (p < 0.001) in the cases (35.98±6.35 mg/dl) compared to controls (42.69±6.09 mg/dl). A significant negative correlation (r-.801, p < 0.01) was found between serum homocysteine and HDL-cholesterol concentration among cases. It can be concluded that elevated serum homocysteine and HDL-cholesterol deficiency were associated with eclampsia. But elevated homocysteine itself might be a factor associated with eclampsia irrespective of lipid profile status. Key Words: Homocysteine, Eclampsia. doi: 10.3329/jafmc.v5i1.2842 JAFMC Bangladesh. Vol 5, No 1 (June) 2009 pp.7-10

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Elevated Serum Homocysteine Associated with Distal Type of Single Small Subcortical Infarction

Current Neurovascular Research ◽

10.2174/1567202617666201029145824 ◽

2020 ◽

Vol 17 ◽

Author(s):

Conghui Liu ◽

Yuan Gao ◽

Bo Song ◽

Yunchao Wang ◽

Lulu Pei ◽

...

Keyword(s):

Elevated Serum ◽

Multivariate Logistic Regression Analysis ◽

Final Analysis ◽

Lowering Therapy ◽

Serum Homocysteine ◽

Standard Template ◽

Lenticulostriate Artery ◽

Baseline Characteristics ◽

Fourth Quartile ◽

Subcortical Infarction

Objective: The aim of this investigation was to examine the association between the serum homocysteine (Hcy) level and the distal single small subcortical infarction (dSSSI). Methods: Consecutive patients were prospectively recruited in a registered hospital-based ischemic stroke database. Baseline characteristics and risk factors of single small subcortical infarction (SSSI), including the serum Hcy level, were assessed. The SSSI located in the lenticulostriate artery (LSA) territory was divided into proximal single small subcortical infarction (pSSSI) and dSSSI based on a standard template on axial diffusion-weighted imaging (DWI). The association between the serum Hcy level and dSSSI was analysed by multivariate logistic regression analysis. Results: Out of 3,247 patients, a total of 572 patients were included in the final analysis. We found that dSSSI had a higher serum Hcy level than pSSSI. Elevated Hcy level was independently correlated with dSSSI. Compared with the lowest quartile, the upper quartiles of Hcy level were independently associated with dSSSI, the odds ratio for the second quartile was 1.748 (95%CI 1.019 to 3.000), 1.824 (95% CI 1.060 to 3.140) for the third quartile, and 2.010 (95% CI 1.155 to 3.497) for the fourth quartile. The restricted cubic spline showed that the higher level of Hcy, the greater risk of developing dSSSI. Conclusion: The dSSSI shows higher serum Hcy level than pSSSI. Elevated serum Hcy is more closely related to dSSSI. In the future, the effectiveness of Hcy-lowering therapy for dSSSI needs to be explored by further clinical studies.

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Homocysteine Level in Schizophrenia Patients

Australian & New Zealand Journal of Psychiatry ◽

10.1080/00048670903001935 ◽

2009 ◽

Vol 43 (8) ◽

pp. 760-765 ◽

Cited By ~ 11

Author(s):

Yin Ying Ma ◽

Chi Chung Shek ◽

Max C. K. Wong ◽

Ka Chee Yip ◽

Roger M. K. Ng ◽

...

Keyword(s):

Homocysteine Level ◽

Blood Donation ◽

Clinical Symptoms ◽

Age Of Onset ◽

Demographic Data ◽

Elevated Serum ◽

Serum Levels ◽

Diagnostic Interview ◽

Healthy Controls ◽

Serum Homocysteine

Objective: Elevated serum levels of homocysteine have been shown to be associated with schizophrenia in some studies, but the evidence is still limited and mixed. The aim of the present study was therefore to evaluate the serum homocysteine level in Chinese in schizophrenia patients and assess its association with clinical phenotypes of the disease. Method: A total of 250 inpatients and 250 healthy controls were identified at Kowloon Hospital and the Red Cross Blood Donation Centre, respectively. Each subject was evaluated with a structured diagnostic interview. Demographic data were collected and blood was analysed for homocysteine level. The Positive and Negative Syndrome Scale was used to grade clinical symptoms of schizophrenia. Confounding factors affecting homocysteine levels were controlled by strict exclusion criteria or statistical methods. Results: Serum homocysteine level was elevated in Chinese schizophrenia patients. Both male (mean, 12.26 µmol L−1; control, 11.40 µmol L−1, p = 0.026) and female (mean, 9.61 µmol L−1; control, 8.33 µmol L−1, p < 0.001) patients had a higher serum homocysteine level than the healthy controls, and these differences persisted after controlling for age. There was no significant association between serum homocysteine level and duration of illness, clinical symptoms or age of onset of schizophrenia. Conclusion: The serum homocysteine levels were elevated in both male and female Chinese schizophrenia patients. The levels were not apparently related to other clinical parameters.

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THU0515 Increased Carotid Intima-Media Thickness Was Related with Elevated Serum Homocysteine Level in Patients with Hyperuricemia

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2016-eular.4806 ◽

2016 ◽

Vol 75 (Suppl 2) ◽

pp. 378.2-378

Author(s):

J.H. Park ◽

S.T. Choi ◽

J.-S. Song

Keyword(s):

Homocysteine Level ◽

Elevated Serum ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Media Thickness ◽

Serum Homocysteine

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Clinical profile and serum homocysteine level in young patients with stroke: a prospective, observational study

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20193260 ◽

2019 ◽

Vol 6 (4) ◽

pp. 1134

Author(s):

Manoharan S. ◽

Sathyasagar K. ◽

Natesh Prabhu M.

Keyword(s):

Homocysteine Level ◽

Elevated Serum ◽

Young Patients ◽

Individual Risk ◽

P Value ◽

Serum Homocysteine ◽

Cortical Vein Thrombosis ◽

Number Of Patients ◽

Significant Difference ◽

Stroke In Young

Background: According to the WHO, stroke is the second most important cause of death in elderly people with age >60 years and fifth leading cause in the age group of 15 to 59 years. Hyperhomocysteinemia has been linked to increased incidence of ischemic strokes. Thus, the aim of the present study was to assess serum homocysteine levels as an individual risk factor of stroke in young patients.Methods: This was a prospective, cross-sectional, single center study performed in 50 patients admitted in the Department of Medicine, Thanjavur Medical College and Hospital, Thanjavur, over a period of 7 months (i.e., from December 2013 to June 2014). Young patients, aged 1545 years, and diagnosed with stroke were included in the study. Serum homocysteine was measured by fluorescein polarization immunoassay (FPIA). Significant difference between the patients with normal and elevated mean serum homocysteine levels was identified by using unpaired t-test. P value ≤0.05 was considered as statistically significant.Results: Majority of the stroke patients were male (78%). Similarly, male patients dominated the total number of patients with elevated serum homocysteine levels (75%). Thirty-two (64%) patients had an elevated serum homocysteine level. There was a significant difference between the patients with increased homocysteine levels as compared to patients with normal homocysteine levels (p value <0.05). Out of 32 patients with hyperhomocysteinemia, 27 (84.38%) patients had ischemic stroke, 4 (12.50%) had cortical vein thrombosis and 1 (3.12%) had hemorrhagic stroke.Conclusions: Findings of the present study confirm that hyperhomocysteinemia is associated with an increased incidence of stroke in young patients. As healthcare providers, we must stress on prevention of stroke, especially by identifying treatable risk factors.

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Evaluation of serum homocysteine in young patients presenting with myocardial infarction: a study from rural Maharashtra

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20204426 ◽

2020 ◽

Vol 7 (11) ◽

pp. 1635

Author(s):

Sudam V. Khedkar ◽

Sudeep Kumar ◽

Praveen Patil ◽

Anant A. Takalkar

Keyword(s):

Myocardial Infarction ◽

Heart Disease ◽

Elevated Serum ◽

Young Patients ◽

Study Cohort ◽

Case Control Studies ◽

Cross Sectional ◽

Male Predominance ◽

Serum Homocysteine ◽

Increased Risk

Background: It has been shown that elevated serum homocysteine levels are associated with an increased risk of ischemic heart disease (IHD) and stroke. Also, higher homocysteine concentrations in IHD or stroke patients than in controls have been reported. Some prospective and case-control studies with inconsistent results, some with highly significant results and others with no association have been observed. Objective of the study was to evaluate the serum homocysteine level in young myocardial infarction patients of rural hospital.Methods: The present hospital based cross sectional observational study was carried out in Department of Medicine, MIMER Medical College and Hospital, Talegaon Dabhade, Pune. The study population included 45 young patients having acute myocardial Infarction coming to our hospital. The data thus collected was entered in MS excel sheet and analysed by using SPSS 24.0 IBM USA.Results: Mean age of the study cohort was 36.7 years with 48.9% cases in between the age of 31-40 years and 33.3% were in the age range of 41-45 years. Male predominance was seen in the study cases with 68.9% males and 31.1% females. Prevalence of hyperhmocysteinemia was observed as 64.4% in present study. Mortality rate in our study was 6.67%. Serum homocysteine and all lipid parameters were in positive correlation except High-density lipoprotein which has negative correlation. Homocysteine levels were correlating significantly with level of atherosclerosis as measured by Gensini score.Conclusions: Coronary heart disease is related to high serum homocysteine concentration. Serum homocysteine levels also correlates well with the severity of MI.

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Risk Factors for Mortality in an Older Veteran Population With infective Endocarditis

The Senior Care Pharmacist ◽

10.4140/tcp.n.2021.258 ◽

2021 ◽

Vol 36 (5) ◽

pp. 258-266

Author(s):

Kari A. Mergenhagen ◽

Kyle Polanski ◽

Erin Conway ◽

Alexander Tito ◽

Fiona Cheung ◽

...

Keyword(s):

Risk Factors ◽

Infective Endocarditis ◽

Older Patients ◽

Multivariate Logistic Regression Analysis ◽

Bivariate Analysis ◽

Close Monitoring ◽

Duke Criteria ◽

Increased Risk ◽

One Year ◽

Minor Criteria

OBJECTIVE: To determine 30-day and 1-year mortality in patients treated for infective endocarditis (IE) in a VA population. The secondary objective was to identify risk factors for increased risk of mortality in veterans diagnosed with IE. DESIGN: A retrospective cohort study. SETTING: Veterans Affairs Western New York Healthcare System PARTICIPANTS: Patients who had a diagnosis of IE between the years 2005 and 2016. Patients were identified via International Classification of Diseases (ICD) codes. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Factors for death and survival were compared using a bivariate analysis. Significant factors were built into a multivariate logistic regression analysis to determine risk factors for death at 30 days and 1 year. RESULTS: Between 2005 and 2016, there were 153 patients with IE. All-cause mortality at 30 days was 14% versus 39% at 1 year. Patients were more likely to die at 1 year with higher Pitt Bacteremia Scores, older age, and lower number of minor criteria according to Duke Criteria. Comorbidities were similar between groups. CONCLUSIONS: Older patients with higher Pitt Bacteremia Scores and lower numbers of minor criteria are more likely to experience mortality at one year. Given the high rates of death at one year, close monitoring, even after completion of therapy may be necessary in older patients. Senior care pharmacists are in a unique position to monitor these patients.

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