Exploratory study of plasma total homocysteine and its relationship to short-term outcome in acute ischaemic stroke in Nigerians
2008

Homocysteine Levels and Stroke Outcomes in Nigerians

Sample size: 155 publication Evidence: moderate

Author Information

Author(s): Okubadejo Njideka U, Oladipo Olajumoke O, Adeyomoye Adekunle A, Awosanya Gbolahan O, Danesi Mustapha A

Primary Institution: University of Lagos, Lagos, Nigeria

Hypothesis

Hcy levels are significantly higher than in normal controls, worsen stroke severity, and increase short-term case fatality rates following acute ischaemic stroke.

Conclusion

Homocysteine levels are not significantly elevated in Nigerians with acute ischaemic stroke, and admission Hcy level is not a determinant of short-term stroke outcome.

Supporting Evidence

  • Total fasting Hcy in stroke patients was 10.2 ± 4.6 umol/L and did not differ significantly from controls (10.1 ± 3.6 umol/L; P = 0.88).
  • Hyperhomocysteinemia was present in 10.1% of stroke cases and 12.8% of controls.
  • Admission NIHSS score was a significant determinant of 4 week outcome measured by GOS score (P < 0.0001).
  • The case fatality rate in this study was 7.2% (5/69).
  • Mean GOS scores at 4 weeks in cases with normal and elevated Hcy were 2.21 ± 1.07 and 3.00 ± 1.73 respectively.

Takeaway

This study looked at how a substance called homocysteine affects people who have had a stroke. It found that homocysteine levels were not higher in stroke patients compared to healthy people, and it didn't affect how well they recovered.

Methodology

The study used a case-control and prospective follow-up design to evaluate hospitalized adults with first-ever acute ischaemic stroke and compared their homocysteine levels to healthy controls.

Limitations

Pre-stroke Hcy levels of stroke cases were not known, limiting the ability to determine changes in Hcy levels.

Participant Demographics

69 stroke patients (31 women, 38 men) and 86 healthy controls (35 women, 51 men) with a mean age of 58.8 years.

Statistical Information

P-Value

0.88

Confidence Interval

0.31 – 2.39

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/1471-2377-8-26

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