Plasma Homocysteine and Ischemic Stroke Patients in Thailand
Tasanee Tantirittisak MD*, Thanyachai Sura MD**, Worachat Moleerergpoom MD***, Suchat Hanchaipiboolkul MD*
Affiliation : * Department of Neurology, Prasat Neurological Institute ** Division of Genetic, Department of Medicine, Ramathibodi Hospital, Mahidol University *** Cardiology Unit, Police General Hospital
Background : Hyperhomocysteinemia was recently found to be a risk factor for stroke; however, the available
data from Thailand is scarce.
Objective : To study plasma homocysteine levels in ischemic stroke and compare it with age-and sex-matched
controls, and to identify the association of plasma homocysteine and subtype of stroke.
Materials and Methods : The authors studied plasma homocysteine levels of ischemic stroke patients with
clinical signs and symptoms of stroke as confirmed by CT scan and compared them with control subjects who
presented with other diseases and no clinical signs and symptoms of stroke between June 2000- May 2001 in
Prasat Neurological institute. Fasting plasma homocysteine was measured by HPLC technique. Abnormal cut
off point of plasma homocysteine was identified and associations of plasma homocysteine and stroke were
studied by using logistic regression analyses.
Results : Two hundred and sixty-eight patients were recruited in the present study (132 controls and 136
ischemic stroke patients). The abnormal cut off point of plasma homocysteine was > 14μmol/L. The authors
found statically significant association of abnormal plasma homocysteine and stroke (p<0.001) with odds
ratio of 4.277 (95%CI 2.551-7.171). After adjusting the confounding factor, the authors found that high
homocysteine was significantly associated with ischemic stroke (p<0.001) with odd ratio of 3.401 (95%CI
1.954-5.922). In the subgroup analyses of type of stroke and abnormal homocysteine, the authors demon-
strated that abnormal homocysteine levels were more pronounced in the large vessel subtype than the small
group.
Conclusion : Abnormal homocysteine level is an independent risk factor of ischemic stroke and more corre-
lated with large vessel subtype.
Keywords : Stroke, Homocysteine
