Role of homocysteine in ischemic cerebrovascular disease

ROLE OF HOMOCYSTEINE IN ISCHEMIC CEREBROVASCULAR DISEASE*Gazi University Medicine School Emergency DepartmentINTRODUCTION: Stroke comes third among mortality causes particularly in developedcountries in our times. Cognitive and motor sequels after the stroke render the productiveindividuals dependent in psychological, physiological, and social aspects. Impact of this onthe economy of the countries also is rather important. This study has been performed todetermine whether high level of homocysteine is an independent risk factor for ischemiccerebrovascular disease or not.MATERIAL AND METHOD: This study was performed in the Adults? Emergency Room ofGazi University, Emergency Medicine Department. This study is a controlled prospectivestudy. Kolmogorov-Smirnov, Shapiro-Wilk, Student?s T test, Chi-square, and Fisher?s Exacttests were used in the evaluation of the statistical data.FINDINGS: Eighty-three adult patients and a group of volunteers consisting of 41 individuals wereincluded in the study. Among the risk factors of stroke, a statistically significant relation between thepresence of hypertension in the medical history and high blood pressure in the physical examinationwas found (p<0.01). A statistically significant relation was found between the decrease in the activitiesof protein C (PC) and antithrombin III (AT-III), which are natural anticoagulants, and stroke wasfound (p<0.05). While no relation was found between the presence of atrial fibrillation in the in themedical histories of patient and control groups, a statistically significant relation was found betweenatrial fibrillation found in ECGs of the study group applying to the emergency room and stroke(p<0.05).When homocysteine levels were compared in the patient and control groups, it was seen that the levelswere extremely high in the patient group (p<0,05).DISCUSSION: Hyperhomocysteinemia is an independent risk factor in a disease like strokewith high morbidity and mortality, and we believe that detecting and treatinghyperhomocysteinemia in the early period will reduce the risk of stroke.