Plasma homocysteine levels and intracranial plaque characteristics: association and clinical relevance in ischemic stroke
Abstract Background Elevated plasma homocysteine (Hcy) is an independent risk factor for ischemic stroke. This study aimed to evaluate the association between Hcy levels and intracranial plaque characteristics and to investigate their clinical relevance in ischemic stroke. Methods Ninety-four patien...
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doaj-8d56d27fc30640bba1fa7766482a59bd2020-11-25T01:23:27ZengBMCBMC Neurology1471-23772018-12-011811710.1186/s12883-018-1203-4Plasma homocysteine levels and intracranial plaque characteristics: association and clinical relevance in ischemic strokeShan shan Lu0Jun Xie1Chun qiu Su2Song Ge3Hai bin Shi4Xun ning Hong5Department of Radiology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Neurology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Nanjing Medical UniversityAbstract Background Elevated plasma homocysteine (Hcy) is an independent risk factor for ischemic stroke. This study aimed to evaluate the association between Hcy levels and intracranial plaque characteristics and to investigate their clinical relevance in ischemic stroke. Methods Ninety-four patients with intracranial atherosclerosis (ICAS) were enrolled. Plasma Hcy levels were measured. Intracranial plaque characteristics including plaque enhancement, stenosis ratio, T2 and T1 hyperintense components were assessed on high-resolution magnetic resonance imaging. Logistic regression model was constructed to analyze the association between high Hcy levels and plaque characteristics, and their synergistic effects to predict the likelihood for ischemic stroke, while adjusting for demographics and traditional atherosclerotic risk factors. Results Elevated Hcy level was associated with strong plaque enhancement independently of age, sex, serum creatinine levels and other atherosclerotic risk factors ((P < 0.001, OR 6.00, 95% confidence interval [CI] 2.28–15.74). Both strong plaque enhancement (P = 0.026, OR 5.63, 95% CI 1.23–25.81) and high Hcy level (P = 0.018, OR 6.20, 95% CI 1.36–28.26) were correlated with acute ischemic stroke. The combination of them strengthened the ability to stratify the likelihood for ischemic stroke, with an improved area under the receiver operating characteristic curve (AUC) of 0.871, significantly higher than that of strong plaque enhancement (0.755) and high Hcy level (0.715) alone (P < 0.05 for both). Conclusions High Hcy level appears to have association with intracranial strong plaque enhancement. The combined assessment of plasma Hcy levels and plaque enhancement may improve ischemic stroke risk stratification.http://link.springer.com/article/10.1186/s12883-018-1203-4HomocysteineAtherosclerosisMagnetic resonance imagingIschemic stroke |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Shan shan Lu Jun Xie Chun qiu Su Song Ge Hai bin Shi Xun ning Hong |
spellingShingle |
Shan shan Lu Jun Xie Chun qiu Su Song Ge Hai bin Shi Xun ning Hong Plasma homocysteine levels and intracranial plaque characteristics: association and clinical relevance in ischemic stroke BMC Neurology Homocysteine Atherosclerosis Magnetic resonance imaging Ischemic stroke |
author_facet |
Shan shan Lu Jun Xie Chun qiu Su Song Ge Hai bin Shi Xun ning Hong |
author_sort |
Shan shan Lu |
title |
Plasma homocysteine levels and intracranial plaque characteristics: association and clinical relevance in ischemic stroke |
title_short |
Plasma homocysteine levels and intracranial plaque characteristics: association and clinical relevance in ischemic stroke |
title_full |
Plasma homocysteine levels and intracranial plaque characteristics: association and clinical relevance in ischemic stroke |
title_fullStr |
Plasma homocysteine levels and intracranial plaque characteristics: association and clinical relevance in ischemic stroke |
title_full_unstemmed |
Plasma homocysteine levels and intracranial plaque characteristics: association and clinical relevance in ischemic stroke |
title_sort |
plasma homocysteine levels and intracranial plaque characteristics: association and clinical relevance in ischemic stroke |
publisher |
BMC |
series |
BMC Neurology |
issn |
1471-2377 |
publishDate |
2018-12-01 |
description |
Abstract Background Elevated plasma homocysteine (Hcy) is an independent risk factor for ischemic stroke. This study aimed to evaluate the association between Hcy levels and intracranial plaque characteristics and to investigate their clinical relevance in ischemic stroke. Methods Ninety-four patients with intracranial atherosclerosis (ICAS) were enrolled. Plasma Hcy levels were measured. Intracranial plaque characteristics including plaque enhancement, stenosis ratio, T2 and T1 hyperintense components were assessed on high-resolution magnetic resonance imaging. Logistic regression model was constructed to analyze the association between high Hcy levels and plaque characteristics, and their synergistic effects to predict the likelihood for ischemic stroke, while adjusting for demographics and traditional atherosclerotic risk factors. Results Elevated Hcy level was associated with strong plaque enhancement independently of age, sex, serum creatinine levels and other atherosclerotic risk factors ((P < 0.001, OR 6.00, 95% confidence interval [CI] 2.28–15.74). Both strong plaque enhancement (P = 0.026, OR 5.63, 95% CI 1.23–25.81) and high Hcy level (P = 0.018, OR 6.20, 95% CI 1.36–28.26) were correlated with acute ischemic stroke. The combination of them strengthened the ability to stratify the likelihood for ischemic stroke, with an improved area under the receiver operating characteristic curve (AUC) of 0.871, significantly higher than that of strong plaque enhancement (0.755) and high Hcy level (0.715) alone (P < 0.05 for both). Conclusions High Hcy level appears to have association with intracranial strong plaque enhancement. The combined assessment of plasma Hcy levels and plaque enhancement may improve ischemic stroke risk stratification. |
topic |
Homocysteine Atherosclerosis Magnetic resonance imaging Ischemic stroke |
url |
http://link.springer.com/article/10.1186/s12883-018-1203-4 |
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