Hyperhomocysteinaemia among Acute Ischaemic Stroke Patients in a Tertiary Care Centre in Thiruvananthapuram, Kerala ??? A Cross-Sectional Study

Author(s): Deepa Gopalakrishna1, Rupa Gopinathan2, Saboora Beegum3, Thomas Iype4

Over the last three decades, prevalence of stroke has been high in India, while
the Western countries have witnessed a downward slide. Epidemiological studies
suggest that hyperhomocysteinaemia might be a potentially modifiable nonlipid
risk factor associated with stroke, in addition to the long-recognized factors like
hypertension, diabetes mellitus, hyperlipidaemia and smoking.
Hyperhomocysteinaemia occurs due to deviation in the metabolic pathway of
methionine, attributed by deficiency of vitamins, enzymes and other factors. The
present study was undertaken to assess the proportion of hyperhomocysteinaemia
in patients with acute ischemic stroke. We also compared the risk factors
associated with stroke and serum levels of homocysteine.
This is a cross sectional observational study conducted in a tertiary care hospital.
The sample size was 140. Both male and female consecutive patients of age more
than 18 years, with first attack of acute ischaemic stroke admitted in the
Department of Neurology were selected. Baseline fasting serum samples were
obtained for testing serum homocysteine levels. Statistical tests used were
proportion, chi square and logistic regression.
Among 140 acute ischaemic stroke patients, total homocysteine level was raised
in 83.6 % cases. The prevalence of moderate hyperhomocysteinaemia in our study
was 65.4 % and intermediate hyperhomocysteinaemia was 17.9 % among stroke
patients. The mean (± SD) homocysteine level was 22.75 (± 8.19).
A strong association was found between hyperhomocysteinaemia and acute
ischaemic stroke. We could not find any significant correlation between total
homocysteine level and most risk factors of stroke.