Hyperhomocysteinemia as a marker of acute stroke severity

Abstract

Summary. Introduction. The most important goals of public health are stroke prevention and reduction of disability and mortality by eliminating risk factors. Elevated blood homocysteine (HC) level, despite conflicting research data, is considered an independent risk factor
for acute stroke (AS). Several studies have examined the effect of hyperhomocysteinemia (HHC) on stroke severity; however, conflicting
evidence has been obtained. Aim: to assess potential HHC impact on AS severity. Materials and Methods. The retrospective case-control
study included 940 patients (690 men and 250 women aged 20–94 years) with verified AS diagnosis who were treated in the neurointensive care unit from January 1, 2015 to July 1, 2024. We analyzed the data of clinical and laboratory tests and AS severity according National
Institutes of Health Stroke Scale (NIHSS) at the time of patient’s admission to the hospital. Results. In patients with NIHSS stroke severity
score≥5 points, HC, C-reactive protein (CRP) and systolic blood pressure (SBP) values were significantly higher than in patients with NIHSS
stroke severity score<5 points (p=0.03; p=0.02; p=0.04, respectively). With HC level>25 μmol/L, stroke severity was significantly higher
(odds ratio=2.26; 95% confidence interval=1.24–4.08; p=0.007). Conclusion. Stroke severity significantly increases with increasing HC, CRP,
SBP values, as well as with comorbid obesity and a history of ischemic heart disease.

For citation: Vorobyeva N.A., Vorontsova A.S., Murashkina А.А. Hyperhomocysteinemia as a marker of acute stroke severity. Tromboz, gemostaz
i reologiya. 2025;(3):57–63. (In Russ.).

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