Heng Zhang, Jiabin Huang, Yongjing Zhou* and Yu Fan* Pages 1 - 9 ( 9 )
Background and Objective: 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.
Homocysteine, ischemic stroke, recurrence, functional outcome, all-cause mortality, meta-analysis.
Department of General Surgery, Nanjing Lishui District People's Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing 211200, Institute of Molecular Biology & Translational Medicine, The Affiliated People’s Hospital, Jiangsu University, No. 8 Dianli Road, 212002 Zhenjiang, Jiangsu, Institute of Molecular Biology & Translational Medicine, The Affiliated People’s Hospital, Jiangsu University, No. 8 Dianli Road, 212002 Zhenjiang, Jiangsu, Institute of Molecular Biology & Translational Medicine, Affiliated Wuxi Second Hospital of Nanjing Medical University, No. 68 Zhongshan Road, 214002 Wuxi, Jiangsu