Determinants and Associations of Homocysteine and Prothrombotic Risk Factors in Kuwaiti Patients with Cerebrovascular Accident

Determinants and Associations of Homocysteine and Prothrombotic Risk Factors in Kuwaiti Patients with Cerebrovascular Accident

Objective: The objective ofthis study was to evaluate the determinants and associations of some prothrombotic risk factors in patients with cerebrovascular accidents (CVAs). Subjects and Methods:In this case-control study, plasma total homocysteine (tHcy), lupus anticoagulant, protein C, protein S,...

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Published in:Medical principles and practice Vol. 17; no. 2; pp. 136 - 142
Main Authors: Mojiminiyi, Olusegun A., Marouf, Rajaa, Al Shayeb, Abdel Raoof, Qurtom, Mohammad, Abdella, Nabila A., Al Wazzan, Hanan, Al Humood, Salah, Abdul Samad, Majeda, El-Muzaini, Hadeel
Format: Journal Article
Language:English
Published: Basel, Switzerland 01-01-2008
Subjects:
Adult
Biomarkers - blood
Case-Control Studies
Female
Homocysteine - blood
Humans
Hyperhomocysteinemia - blood
Hyperhomocysteinemia - epidemiology
Kuwait - epidemiology
Logistic Models
Male
Middle Aged
Original Paper
Risk Factors
Stroke - blood
Stroke - epidemiology
Stroke - prevention & control
Thrombophilia - blood
Kuwait
Cerebrovascular accident
Homocysteine
Prothrombotic risk factors
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Summary:Objective: The objective ofthis study was to evaluate the determinants and associations of some prothrombotic risk factors in patients with cerebrovascular accidents (CVAs). Subjects and Methods:In this case-control study, plasma total homocysteine (tHcy), lupus anticoagulant, protein C, protein S, activated protein C resistance (APC-R) and antithrombin were measured in 102 patients (60 males and 42 females) and 167 controls (87 males, 80 females). Serum vitamin B 12 , folate, red cell folate, creatinine, lipid profile and glucose were also determined. Glomerular filtration rate (GFR) was calculated. Results:13 (22%) of the 60 male patients, and 16 (39%) of the 42 female patients had hyperhomocysteinemia. Median (interquartile range) tHcy was higher in male patients [11.22 µmol/l (9.60–15.40)] than female patients [10.05 µmol/l (8.72–17.54)]. On binary logistic regression analysis, the significant (p < 0.05) determinants of tHcy were urea, creatinine and GFR. Comparing patients with control subjects showed that tHcy, age, fasting glucose, urea, serum creatinine, white blood cell count, protein S, APC-R and factor VIII were significantly higher, while protein C, factor II, total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol were significantly lower in patients. Lupus anticoagulant was not associated with tHcy and not detected in patients and controls. Low concentrations of vitamins B 12 and folate were not associated with tHcy. Logistic regression analysis showed a significant association of tHcy with CVA (OR = 9.55; p = 0.047) in males in the presence of other traditional CVA risk factors but tHcy is not independently associated with CVA in females. Conclusion:Hyperhomocysteinemia is common in Kuwaiti patients with CVA and tHcy probably interacts with prothrombotic factors (protein C, APC-R and factor VIII) to increase CVA risk. The main determinants, age and GFR markers, should be kept in mind when determining the risk associated with tHcy.
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ISSN:1011-7571
1423-0151
DOI:10.1159/000112968