The influence of hyperhomocysteinemia on the recurrent ischemic vascular events and relative death of stroke patients

Objective To explore the possible influence of the hyperhomocysteinemia(Hhcy)on the occurence of recurrent ischemic stroke(IS),death,coronary and peripheral artery ischemic events in hope for finding some valuable information for the synthetically therapy of ischemic vascular diseases.Methods We determined the free plasma homocysteine(Hcy)of 245 patients with IS and divided them into Hhcy group and non-hyperhomocysteinemia(Nhhcy)group according the plasma Hcy level of 52 homeochronous healthy controls.We follow-up the recurrence of IS and the occurrence of death,coronary and peripheral artery ischemic events in the 2 groups.Results The incidence of recurrent IS of Hhcy group was statistically higher than that of Nhhcy group(52.63% versus 24.67,P0.01).The mortality of Hhcy group was also statistically higher than that of Nhhcy group(12.63% versus 3.33%,P0.01),so was the incidence of the coronary ischemic events(18.95% versus 10.00%,P0.05).The incidence of the peripheral artery ischemic events of Hhcy group was higher than that of Nhhcy group,but the diference was not statistically significant(5.26% versus 2.67%,P0.05).The proportion of the patients with more than 2 kinds of ischemic events in Hhcy group was statistically higher than that in Nhhcy group(17.89% versus 5.33%,P0.01).The diference of incidence of all ischemic events between the 2 group was statistically significant(Hhcy :57.89%;Nhhcy:32.00%;P0.01).By forward stepwise logistic analysis,we found that the increased Hcy was an independent risk factor of the recurrent ischemic vascular events(OR was 1.174,95%CI was 1.119~1.233;P0.05).Conclusion Hhcy is correlated with the recurrent ischemic vascular events and death prognosis of ischemic stroke patients.