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(Stroke. 2001;32:275.)
© 2001 American Heart Association, Inc.

Letters to the Editor

Hyperhomocysteinemia and Oxidative Stress in Ischemic Stroke

Maria Cristina Polidori, MD; Antonio Cherubini, MD; Umberto Senin, MD Patrizia Mecocci, MD, PhD

Institute of Gerontology and Geriatrics, Perugia University Hospital, Perugia, Italy

To the Editor:

We read with interest the data recently published by El Kossi and Zakhary.¹ In this study, the authors found significantly higher levels of plasma homocyst(e)ine, lipid peroxides, and oxidation products of nitric oxide, as well as significantly lower plasma vitamin C levels, in 30 patients with thrombotic cerebrovascular stroke within 2 hours from the onset of symptoms compared with healthy control subjects.¹ Furthermore, the authors observed a strong positive correlation between homocyst(e)ine and lipid peroxides and an inverse relationship both between plasma vitamin C and homocyst(e)ine levels and between plasma vitamin C and lipid peroxide levels. As the authors noted, oxidative stress may play an important role in the pathogenesis of ischemic brain injury,² and homocyst(e)ine might act as pro-oxidant in stroke.³ With their work, they concluded that indeed the association between hyperhomocyst(e)inemia and indexes of oxidative stress might reflect an ischemia-related free radical hyperproduction, and lowering plasma homocysteine levels might help in prevention of oxidative damage to the brain in stroke patients.¹

We studied 42 patients (24 men and 18 women, aged 85.6±2.3 years) 5.1±1.4 days after the onset of ischemic stroke of thromboembolic origin. Patients with transient ischemic attack, highly disabling stroke as assessed by Rankin Scale score, alterations of lipid metabolism, severe organ failure (eg, kidney, liver), and smoking habit, as well as patients taking antioxidant supplements or unable to swallow/eat, were excluded. Patients were compared with 42 healthy controls (16 men and 26 women, aged 85.2±2.1 years). Blood was drawn in all subjects . . . [Full Text of this Article]

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