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Relation between homocysteine and non‐fatal stroke in peripheral arterial disease
Author(s) -
Haltmayer M.,
Mueller T.,
Lange W.,
Luft C.,
Hainzl A.,
Poelz W.,
Haidinger D.
Publication year - 2002
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1046/j.1468-1331.2002.00438.x
Subject(s) - medicine , stroke (engine) , homocysteine , diabetes mellitus , vascular disease , odds ratio , logistic regression , cardiology , population , peripheral , stenosis , arterial disease , endocrinology , mechanical engineering , environmental health , engineering
There are currently no data on whether high total serum homocysteine (tHcy) is predictive for cerebrovascular events in patients with symptomatic peripheral arterial disease (PAD). Therefore, the purpose of this study was to determine whether high tHcy levels were related to the evidence of non‐fatal stroke in PAD. Evidence of non‐fatal atherothrombotic stroke events was verified in 450 consecutive male patients, admitted for inpatient treatment of symptomatic PAD. The extent of carotid stenosis was evaluated by colour duplex Doppler measurement and fasting tHcy was determined by high‐performance liquid chromatography. Within the population of 450 PAD patients a documented history of ischaemic stroke was evident in 50 subjects. The median tHcy values were significantly higher in PAD patients with stroke (18.6 μmol/l) than in PAD patients without stroke (15.1 μmol/l, P < 0.001). Logistic regression analysis revealed that tHcy was an independent and significant predictor ( P =0.001) with an odds ratio (OR) of 1.37 for an increment of 5 μmol/l. In this multivariate model, diabetes mellitus (OR=2.34, P =0.011) and carotid stenosis ≥50% (OR=2.59, P =0.005) were also independently related to clinical cerebrovascular disease in PAD. In conclusion, the present study demonstrates an association of tHcy and evidence of non‐fatal atherothrombotic stroke in patients with symptomatic PAD. This could be important, as a reduction of elevated tHcy concentrations by vitamin supplement might decrease the high frequency of cerebrovascular complications in PAD patients.