Stroke, Vol 21, 572-576, Copyright © 1990 by American Heart Association
BM Coull, MR Malinow, N Beamer, G Sexton, F Nordt and P de Garmo
Homocyst(e)ine refers to the sulfur-containing amino acids homocysteine,
homocystine, and homocysteine-cysteine mixed disulfide, which normally
exist in plasma in both the free and protein-bound forms. Marked
hyperhomocyst(e)inemia is associated with well-recognized complications of
occlusive thrombotic events and a characteristic syndrome. It is less clear
whether mild to moderate elevations in plasma homocyst(e)ine concentrations
(i.e., 1.5-5-fold increases) also represent a risk factor for stroke and,
if so, whether it is independent of other recognized risk factors. To
examine these questions we compared the plasma homocyst(e)ine levels in 41
patients with acute strokes, 27 patients with transient ischemic attacks,
31 patients with recognized risk factors for but no recent symptoms of
cerebrovascular disease, and 31 normal volunteers (controls). Plasma
homocyst(e)ine concentration was moderately but significantly higher in the
patients than in the controls (p less than 0.0001). Approximately 30% of
the patients had homocyst(e)ine levels higher than the controls. No
relation was found between homocyst(e)ine concentration and other
recognized stroke risk factors or stroke type; however, a positive
correlation was found between serum uric acid and plasma homocyst(e)ine
levels. These data suggest that a moderately elevated plasma homocyst(e)ine
concentration may be an independent risk factor for cerebrovascular
disease.
ARTICLES
Elevated plasma homocyst(e)ine concentration as a possible independent risk factor for stroke
Department of Neurology, Veterans Administration Medical Center, Portland, OR 97207.
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