دورية أكاديمية
Homocysteinemia and early outcome of acute ischemic stroke in elderly patients.
| العنوان: | Homocysteinemia and early outcome of acute ischemic stroke in elderly patients. |
|---|---|
| المؤلفون: | Forti P; Department of Medical and Surgical Sciences (DIMEC) University of Bologna Bologna Italy., Maioli F; Geriatric Stroke Unit Medical Department Maggiore Hospital Bologna Italy., Arnone G; Geriatric Stroke Unit Medical Department Maggiore Hospital Bologna Italy., Coveri M; Geriatric Stroke Unit Medical Department Maggiore Hospital Bologna Italy., Pirazzoli GL; Department of Medical and Surgical Sciences (DIMEC) University of Bologna Bologna Italy., Zoli M; Department of Medical and Surgical Sciences (DIMEC) University of Bologna Bologna Italy., Procaccianti G; Neurology Stroke Unit Institute of Neurological Sciences (IRCCS) Maggiore Hospital Bologna Italy. |
| المصدر: | Brain and behavior [Brain Behav] 2016 Apr 05; Vol. 6 (5), pp. e00460. Date of Electronic Publication: 2016 Apr 05 (Print Publication: 2016). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: John Wiley & Sons Country of Publication: United States NLM ID: 101570837 Publication Model: eCollection Cited Medium: Internet ISSN: 2162-3279 (Electronic) NLM ISO Abbreviation: Brain Behav Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Hoboken, NJ : John Wiley & Sons |
| مواضيع طبية MeSH: | Outcome Assessment, Health Care*, Brain Ischemia/*blood , Homocysteine/*blood , Hyperhomocysteinemia/*blood , Stroke/*blood, Aged ; Aged, 80 and over ; Brain Ischemia/mortality ; Female ; Humans ; Hyperhomocysteinemia/mortality ; Male ; Stroke/mortality |
| مستخلص: | Objectives: Plasma total homocysteine (tHcy) is a risk factor for ischemic stroke (IS) but its relationship with IS outcome is uncertain. Moreover, previous studies underrepresented older IS patients, although risk of both hyperhomocysteinemia and IS increases with age. We investigated whether, in elderly patients with acute IS, tHcy measured on admission to the Stroke Unit (SU) is an independent predictor of SU discharge outcomes. Materials and Methods: Data are for 644 consecutive patients aged 80.3 ± 8.7 years, admitted to an Italian SU with diagnosis of acute IS. Plasma tHcy was measured on SU admission. Investigated outcomes included mortality during SU stay and poor functional status (modified Rankin Scale score ≥3) at SU discharge for survivors. The association of plasma tHcy with the study outcomes was assessed using Odds Ratios (OR) and their corresponding 95% confidence intervals (95%CI) from logistic regression models adjusted for demographics, pre-stroke features, IS severity, and laboratory data on SU admission (serum C-reactive protein, serum albumin, and renal function). Results: Median plasma tHcy was 16.7 μmol/L (interquartile range, 13.0-23.3 μmol/L). Outcome incidence was 5.3% for mortality and 49.7% for poor functional status. Plasma tHcy was unrelated to mortality in both univariate and multivariable-adjusted analyses. Conversely, plasma tHcy was associated with poor functional status of survivors in univariate analyses (P = 0.014). Multivariable-adjusted analyses showed that, compared to normal homocysteinemia (tHcy <16 μmol/L), risk of being discharged with poor functional status significantly increased for moderate (tHcy ≥30 mol/L) but not mild (16.0-29.9 μmol/L) hyperhomocysteinemia. Conclusions: In elderly patients with acute IS, high admission plasma tHcy is unrelated to mortality during SU stay but is an independent predictor of poor functional status at SU discharge in survivors. The association, however, is limited to patients with moderate hyperhomocysteinemia. |
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| فهرسة مساهمة: | Keywords: Acute ischemic stroke; over 80 years oldstroke outcome; total homocysteine |
| المشرفين على المادة: | 0LVT1QZ0BA (Homocysteine) |
| SCR Disease Name: | Homocysteinemia |
| تواريخ الأحداث: | Date Created: 20160421 Date Completed: 20171023 Latest Revision: 20210109 |
| رمز التحديث: | 20240628 |
| مُعرف محوري في PubMed: | PMC4828585 |
| DOI: | 10.1002/brb3.460 |
| PMID: | 27096104 |
| قاعدة البيانات: | MEDLINE |
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