The relation of plasma total homocysteine levels to prevalent cardiovascular disease in older patients with ischemic stroke

The objectives of this study were to describe the distribution of serum lev els of total homocysteine (HCys) in a sample of older patients consecutivel y admitted following acute ischemic cerebral stroke, as compared with healt hy controls, and to test for possible relationships of HCys levels to some of the prevalent cardiovascular diseases in these stroke patients. One hund red and thirty-seven stroke patients and 132 healthy controls (age greater than or equal to 60) participated in this study. HCys levels were determine d by HPLC method with fluorescence detection. Correlates of HCys levels and clinical data were examined. The results showed that stroke patients (mean age 74.6+/-9.2) had higher HCys levels as compared with controls (13.8 and 9.8 respectively, p<0.001). Advanced age, male gender, absence of diabetes and a positive history of previous myocardial infarction were the factors associated with HCys levels higher than 10 mmol/L (Odds ratio 2.72, 2.54, 3 .12 3.55, respectively). We conclude that hyperhomocysteinemia is prevalent in older patients with acute ischemic stroke. Few factors associated with increased risk for hyperhomocysteinemia in these stroke patients were ident ified. The study supports earlier observations regarding elevated HCys leve ls in stroke patients and increased prevalence of associated cardiovascular disease. (Aging Clin. Exp. Res. 12: 48-52, 2000) (C)2000, Editrice Kurtis.