Title:Association of Homocysteine Level with Adverse Outcomes in Patients with Acute Ischemic Stroke: A Meta-Analysis
Volume: 28
Issue: 36
Author(s): Heng Zhang, Jiabin Huang, Yongjing Zhou*Yu Fan*
Affiliation:
- Institute of Molecular Biology & Translational Medicine, The Affiliated People’s Hospital, Jiangsu University, No. 8 Dianli Road, 212002 Zhenjiang, Jiangsu,China
- Institute of Molecular Biology & Translational Medicine, The Affiliated People’s Hospital, Jiangsu University, No. 8 Dianli Road, 212002 Zhenjiang, Jiangsu,China
Keywords:
Homocysteine, ischemic stroke, recurrence, functional outcome, all-cause mortality, meta-analysis.
Abstract:
Background: Studies on the prognostic value of homocysteine level have
yielded controversial results in patients with acute ischemic stroke (AIS). The aim of this
meta-analysis was to evaluate the prognostic utility of homocysteine among patients with
AIS in terms of recurrent stroke, poor functional outcome or all-cause mortality.
Methods: Two independent authors searched the articles published in PubMed and Embase
databases prior to March 31, 2020. Original studies that investigated the value of homocysteine
level in predicting recurrent stroke, poor functional outcome (modified
Rankin Scale ≥ 3) or all-cause mortality in AIS patients were eligible.
Results: Eleven articles (10 studies) that enrolled 19,435 patients with AIS were included.
Meta-analysis indicated that the patients with the highest homocysteine level had an
increased risk of all-cause mortality (risk ratio [RR] 1.40; 95% confidence interval [CI]
1.26-1.55). However, elevated homocysteine level was not significantly associated with
recurrent stroke (RR 1.28; 95% CI 0.99-1.65) or poor functional outcome (RR 1.71; 95%
CI 0.77-3.83).
Conclusion: Elevated homocysteine level is independently associated with a higher risk
of all-cause mortality but not recurrent stroke or poor functional outcome in patients with
AIS. However, additional well-designed studies are required to confirm the findings of
this meta-analysis.
