Serum homocysteine- A predictor for acute stroke in a territary care hospital in Mumbai

Abstract

Epidemiology studies have shown that increased serum homocysteine levels are associated with an increased risk of thromboembolic disease. Controversy exists over which subtype of stroke is allied to deranged homocysteine levels. we aimed to investigate whether elevated homocysteine levels are a risk factor to stroke, severity associated with stroke and which subtype of stroke is associated with stroke. An observational study was conducted in a territory health care centre; patients admitted in stroke unit of territory health care center were recruited in the study. Demographics, stroke severity through NIHSS and homocysteine, Vitam B12 and Vitamin D3 levels were assessed at time of admission. The subtype of stroke was determined based on the classification of subtype of stroke‘TOAST’Trial. Normal homocysteine levels was taken at6.0-16.0 micromol/litre. Out of the 120 patients screened,60.83% had an increase serum homocysteine levels on admission,39.2% had hypertension, and 17% had h/o smoking. Out of 120, 29 had large vessel stroke, 46 had cardio-embolic stroke,22 had lacunar infarcts and 23 had undetermined causes of stroke based on the TOAST criteria. Homocysteine was found to be higher in the patients with cardio-embolic subtype of stroke. There was significant difference in the vitaminb12 level in the large vessels stroke subtype. There was no significant correlation between serum levels and stroke severity. Homocysteine can be a risk factor associated with stroke in patients living in Mumbai. They have a significant risk of developing cardio-embolic strokes. Routine check of Homocysteine levels will help in preventing stroke in these individuals.