Association between homocysteine level and intima-media thickness in patients with first ischemic stroke

Objective - Elevated plasma homocysteine may be a causal risk factor for atherosclerosis but this remains controversial. We evaluated the relationship between intima-media thickness of carotid arteries and plasma level of homocysteine in first ischemic stroke patients. Methods and Results - In the patient group, 175 patients with ischemic stroke (89 men and 86 women; mean age 61.2years [SD 6.83]) and in the control group, 110 healthy subjects without ischemic stroke with healthy subjects (58 men and 52 women; mean age 59.8 years [SD 8.15]) were studied. There was not a statistical difference between two groups regarding age, sex, and conventional vascular risk factors between two groups. Logistic regression analysis was carried out by use of a backward selection strategy with continuous variables (age, homocysteine,folate) and categorical variables (hypertension, diabetes mellitus, hypercholesterolemia, history of previous vascular events and smoking) as independent variables and ischemic stroke as the dependent variable. Important independent risk factors for IMT were hypertension (OR 1.08; 95% Cl 1.03 to 1.13, p= 0.001), homocysteine level (OR 12.1; 95% Cl 2.8 to 55, p= 0.002), hypercholesterolemia (OR 2.26; 95% Cl 1.35 to 3.81, p= 0.002), diabetes mellitus (OR 8.01, 95% Cl 2.1 to 28.2, p=0.003), previous vascular events (OR 2.0 1; 95 % Cl 1.22 to 3.31, p=0.005), current smoker (OR 2.11, 95% Cl 1.01 to 3.74, p=0.03), serum folate (OR 7.06; 95%Cl 7.0 to 7.8 1, p=0.002). Conclusions - Finally, increased plasma homocysteine level was an independent risk factor for intima media thickness in first ischemic stroke. So, we think that further comprehensive and long-term studies necessary on this subject.