The study of plasma homocysteine level as a risk factor for ischemic strokes in young patients

Abstract

Background: According to the WHO, stroke is second leading cause of death for people above the age of 60 years & fifth leading cause in people aged 15 to 59 years old. Each year, nearly six million people worldwide die from stroke. One in six people worldwide will have a stroke in their lifetime. Approximately one-quarter of 45-year-old men will have a stroke before they reach the age of 85. Stroke is also important condition in young people and can occur at any age, including in utero, neonatal period (it is the major cause of cerebral palsy), childhood and young adult life. One-quarter of all strokes occur in people below the age of 65.Methods: This prospective observational case control study was carried on 30 young ischemic stroke patients with 30 control match persons over a period of 20 months, from December 2011 to August 2013 at Tertiary Care Hospital Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, India.Results: Total plasma fasting homocysteine level in case group was 30.10±14.8 µmol/L and control group was 13±5.3 µmol/L, (p=0.001). Elevated fasting homocysteine level was found in 76.66. 0% of ischemic stroke cases and in 10% of healthy controls (p=0.001). Serum homocysteine levels were higher in subjects having risk factors such as dyslipidemia (p value <0.001), active lifestyle (p value <0.05) and smoking (p value<0.05). Serum homocysteine did not show any significant relation with age, sex, diabetes mellitus, diet pattern and defective coagulation (p value >1).Conclusions: The present study revealed that hyperhomocysteinemia appears to be an important risk factor for young ischemic strokes. It is therefore important to use serum homocysteine level as an important tool to investigate all cases of young ischemic strokes and also in those who are at risk of developing it. Significant correlation has been found between homocysteine concentration and young ischemic strokes.