Title:Plasma Homocysteine and Prognosis of Patients with Recanalization after Acute Basilar Artery Occlusion: An Analysis from the Acute Basilar Artery Occlusion Study (BASILAR) Nationwide Prospective Registry
Volume: 18
Issue: 2
Author(s): Xiangrong Sun, Qian Yang, Xinyue Ju, Shenglin Wang, Zhongming Qiu, Hongfei Sang, Wenjie Zi, Qingwu Yang and Guohui Jiang*
Affiliation:
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College, 63 Wenhua Road, Nanchong 637000, China; Institute of Neurological Diseases, North Sichuan Medical College, 234 Fujiang Road, Nanchong, Sichuan,China
Keywords:
Plasma homocysteine, acute basilar artery occlusion (ABAO), endovascular treatment, plasminogen activator,
stroke, clinical prognosis.
Abstract:
Background: Few studies have investigated the association between plasma Homocysteine
(Hcy) levels in patients with recanalization after acute Basilar Artery Occlusion (BAO).
Objective: This study investigated the predictive value of Hcy on the clinical prognosis of patients
with recanalization after acute BAO.
Methods: Altogether, 829 participants were recruited from the standard medical treatment plus endovascular
treatment group of the Acute Basilar Artery Occlusion Study (BASILAR). Hcy levels
were measured the morning after admission. The primary outcome was a combination of death and
major disability (modified Rankin Scale score 4-6) at 90 days, and the secondary outcome was the
mortality of patients with recanalization after acute BAO within 90 days. We used multivariable logistic
regression modeling to estimate the association between Hcy and prognosis in our participants
at 90 days.
Results: Altogether, 647 patients were assessed, and 302 patients were included in this study. The
median was 12.88 μmol/L, and the mean Hcy concentration was 15.49 μmol/L. Elevated plasma
Hcy levels (Hcy >12.88 μmol/L) were associated with poor functional outcomes (adjusted odds ratio
1.922, 95% confidence interval (CI) 1.048-3.528, P=0.035), but not with mortality (adjusted
odds ratio 1.605, 95% CI 0.986-2.489, P=0.058). In further subgroup analysis, the conclusion was
consistent in all predefined subgroups.
Conclusion: Our analysis suggests that elevated plasma Hcy levels have a predictive value for functional
outcomes in patients with recanalization after acute BAO during the 90-day follow-up period,
but not for mortality.
