Observational Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2019; 7(22): 3751-3756
Published online Nov 26, 2019. doi: 10.12998/wjcc.v7.i22.3751
Relationship between homocysteine level and prognosis of elderly patients with acute ischemic stroke treated by thrombolysis with recombinant tissue plasminogen activator
Juan Li, Fan Zhou, Feng-Xue Wu
Juan Li, Feng-Xue Wu, Department of General Practice, Jingzhou Central Hospital, Jingzhou 434100, Hubei Province, China
Fan Zhou, Department of Neurology, Jingzhou Central Hospital, Jingzhou 434100, Hubei Province, China
Author contributions: Li J, Zhou F, and Wu FX contributed to study design and manuscript drafting; Li J, Zhou F, and Wu FX revised the manuscript; all authors proofed the manuscript for its publication.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Jingzhou Central Hospital.
Informed consent statement: All study participants provided informed consent.
Conflict-of-interest statement: There are no conflicts of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors revised the manuscript according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Feng-Xue Wu, MD, Chief Doctor, Director, Department of General Practice, Jingzhou Central Hospital, No. 60, Jingzhong Road, Jingzhou 434100, Hubei Province, China. 37016653@qq.com
Received: September 7, 2019
Peer-review started: September 7, 2019
First decision: September 23, 2019
Revised: October 31, 2019
Accepted: November 14, 2019
Article in press: November 14, 2019
Published online: November 26, 2019
Processing time: 80 Days and 3.8 Hours
Abstract
BACKGROUND

Acute ischemic stroke (AIS) is mainly caused by cerebral blood flow disorders, which further leads to ischemic brain necrosis or encephalomalacia. The role of homocysteine (Hcy), an independent risk factor for cardiovascular disease, in the development of atherosclerosis is gradually revealed. However, studies are still rare and little is known about the relationship of Hcy level with the prognosis.

AIM

To explore the relationship between Hcy level and prognosis in elderly patients with AIS after thrombolytic therapy with recombinant tissue plasminogen activator (rtPA).

METHODS

A total of 120 patients with acute ischemic stroke who were admitted to Jingzhou Central Hospital and underwent recombinant tissue plasminogen activator treatment were randomly selected from January 2017 to December 2018. They were divided into two groups according to the level of Hcy, with 60 patients in each group. Patients with Hcy ≥ 18.54 umol/L were included into a high-level group and those with Hcy < 18.54 umol/L were included into a low-level group. The outcomes were analyzed in the two groups after the treatment.

RESULTS

The National institute of Health Stroke Scale (NIHSS) scores were significantly higher in the high-level group than in the low-level group before and 1 h after the treatment (P < 0.05). There was no significant difference in NIHSS scores between the two groups at 12 and 24 h after the treatment (P > 0.05). The Modified Rankin scale (MRS) scores were significantly higher in the high-level group than in the low-level group before and 1 h after the treatment (P < 0.05). There was no significant difference in MRS scores between the two groups at 12 and 24 h after the treatment (P > 0.05). NIHSS and MRS scores were positively correlated with the prognosis after thrombolytic therapy (P < 0.05).

CONCLUSION

The level of Hcy is closely related to the prognosis of elderly patients with acute ischemic stroke, and after rtPA treatment, the prognosis of elderly patients is improved significantly.

Keywords: Hcy level; Acute ischemic stroke; Thrombolytic therapy; Prognosis

Core tip: Acute ischemic stroke (AIS) is one of the most common strokes that occur in the clinical practice. It is mainly caused by cerebral blood flow disorders, which further leads to ischemic brain necrosis or encephalomalacia. Studies are still rare and little is known about the relationship of Hcy level with the prognosis. The present study analyzed the relationship between homocysteine level and the prognosis of elderly patients with AIS after the administration of recombinant tissue plasminogen activator.