Abstract

MONTALVAN-AYALA, Víctor; PALACIN-ARIAS, Lorenzo; MORALES-CUERVO, Vicky  and  PACHAS-VICUNA, Carlos. Relationship between hyperhomocysteinemia and cerebrovascular disease of small vessels in the neurology Department of Hospital Almenara-EsSalud, Lima. Rev Neuropsiquiatr [online]. 2016, vol.79, n.3, pp.137-141. ISSN 0034-8597.

Objectives: Hyperhomocysteinemia has been described as a risk factor for coronary disease and ischemic stroke. The aim of this paper is to determine the association between hyperhomocisteinemia and ischemic stroke caused by small vessels disease (SVD) in a group of non-cardioembolic stroke patients. Material and methods: One hundred and one clinical records of stroke patients admitted during 5 months were included. Stroke patients with a cardioembolic etiology were excluded. Stroke was classified into infarctions due to SVD and other non-cardioembolic infarctions (non-SVD) by using Adams criteria. We compared the levels of serum homocysteine between both groups using the “T student” test for independent samples. Bivariate and multivariate analyses for confounding factors were performed. Results: Out of 216 clinical records reviewed, 101 patients with a non-cardioembolic stroke were included. In SVD group 54,5% had Hyperhomocysteinemia in contrast to 26,4% founded in non-SVD group (p = 0,008). The mean level of plasmatic homocysteine in SVD group was 14,37umol/L; and 11,32 umol/L, in non-SVD group (p<0.0001). In multivariate analysis we found a significant relationship between Hiperhomocysteine and SVD infarctions (adjusted OR = 2.7; p = 0.006). Conclusions: Hyperhomocysteine was strongly associated with SVD, independently from other vascular risk factors.

Keywords : Homocysteine; stroke; small; vessels; disease.

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