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Homocysteine and carotid intima-media thickness in ischemic stroke patients are not correlated

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George Ntaios1, Christos Savopoulos1, Apostolos Hatzitolios1, Ippoliti Ekonomou2, Evangelos Destanis2, Ioannis Chryssogonidis2, Anastasia Chatzinikolaou3, Ifigenia Pidonia3, Dimitrios Karamitsos1

1First Propedeutic Department of Internal Medicine; 2Department of Radiology; 3Department of Biochemistry, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

Introduction: Hyperhomocysteinemia has been linked to cardiovascular morbidity and mortality by numerous authors. Whether this association is causal or not remains uncertain. The aim of the study was to investigate the association of hyperhomocysteinemia with the degree of carotid atherosclerosis in stroke patients.

Methods: We studied 97 Greek patients in our stroke unit who were hospitalized as a result of ischemic stroke between March 2006 and May 2007. The patients were divided into two groups: the first (52 patients) included stroke patients with serum levels of homocysteine below 15 µmol/L, but in the second group (45 patients) serum homocysteine exceeded this value. We measured carotid intima-media thickness (cIMT) in all patients and correlated it with serum homocysteine.

Results: The mean homocysteine concentration was 11.5 µmol/L in the first group and 21.5 µmol/L in the second group. Carotid IMT was 1.012 mm in the first group, and 1.015 mm in the second group, an insignificant difference. On the contrary, serum folate concentration was 21.3 nmol/L in the first group compared with 16.7 nmol/L in the second group (p < 0.001). VitB12 was 401 pmol/L in the first group and 340 pmol/L in the second group, a statistically significant difference (p < 0.001).

Conclusions: Serum levels of homocysteine were not correlated with cIMT in ischemic stroke patients. Both folate and vitB12 were decreased in hyperhomocysteinemic ischemic stroke patients.

Keywords: homocysteine, carotid intima-media thickness, ischemic stroke

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