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homocysteine atrial fibrillation stroke

Ashkan Shoamanesh, Sarah R Preis, Alexa S Beiser, Carlos S Kase, Philip A Wolf, Ramachandran S Vasan, Emelia J Benjamin, Sudha Seshadri, Jose R Romero
OBJECTIVE: We related a panel of inflammatory biomarkers to risk of incident ischemic stroke (IIS) in a community-dwelling sample. METHODS: Stroke-free Framingham offspring attending examination cycle 7 (1998-2001) had 15 circulating inflammatory biomarkers measured. Cox proportional hazard models were used to calculate the hazard ratios (HRs) of IIS per SD increment of each biomarker. Model 1 included age and sex. Model 2 additionally adjusted for systolic blood pressure, hypertension treatment, current smoking, diabetes, cardiovascular disease, and atrial fibrillation...
September 20, 2016: Neurology
J David Spence
Elevated levels of total homocysteine impair endothelial dysfunction and increase thrombosis. Homocysteine is causal in animal models, and in human studies, elevated total homocysteine is significantly associated with carotid atherosclerosis, lacunar infarction, and markedly increased risk of stroke in atrial fibrillation. Because two of the early large trials of B vitamin therapy (Vitamin Intervention for Stroke Prevention and the Norwegian Vitamin Study) did not show any reduction of stroke, and the Heart Outcomes Prevention Evaluation 2 trial was mistakenly interpreted as not showing a reduction of stroke (because the authors could not think of a biological difference between stroke and myocardial infarction), there has been widespread pessimism regarding treatment to lower total homocysteine for stroke prevention...
October 2016: International Journal of Stroke: Official Journal of the International Stroke Society
Maurizio Acampa, Pietro Enea Lazzerini, Francesca Guideri, Rossana Tassi, Giuseppe Martini
Cerebrovascular complications after orthotopic heart transplantation (OHT) are more common in comparison with neurological sequelae subsequent to routine cardiac surgery. Ischemic stroke and transient ischemic attack (TIA) are more common (with an incidence of up to 13%) than intracranial hemorrhage (2.5%). Clinically, ischemic stroke is manifested by the appearance of focal neurologic deficits, although sometimes a stroke may be silent or manifests itself by the appearance of encephalopathy, reflecting a diffuse brain disorder...
May 2016: Journal of Stroke
Hee Jung Park, Tae Uk Kim, Jung Keun Hyun, Jung Yoon Kim
OBJECTIVE: To investigate the association of family history of stroke with functional outcomes in stroke patients in Korea. METHODS: A case-control study was conducted. A total of 170 patients who were admitted to a rehabilitation unit were included. Risk factors for stroke such as age, sex, diabetes mellitus, hypertension, atrial fibrillation, smoking, high blood cholesterol and homocysteine level, obesity, and family history of stroke were taken into account. Stroke subtypes were the following: large vessel infarct, small vessel infarct, embolic infarct, subarachnoid hemorrhage, and intracranial hemorrhage...
December 2015: Annals of Rehabilitation Medicine
Souvik Sen, Katherine Dahlberg, Abigail Case, Stephanie Paolini, Joselyn Burdine, Leema R Peddareddygari, Raji P Grewal
A majority of stroke research in the United States focuses on Caucasian and African-American populations, limiting the amount of comparative stroke data available on other racial and ethnic groups. The purpose of this research was to examine differences in stroke risk factors/subtypes between minority stroke patient groups in the United States (Asian-Indian, African-American, and Hispanic), using a Caucasian reference group. All patients had a comprehensive stroke work-up to ascertain their stroke risk factors and their stroke etiology applying TOAST criteria...
August 2013: International Journal of Neuroscience
Graeme J Hankey, John W Eikelboom, Qilong Yi, Kennedy R Lees, Christopher Chen, Denis Xavier, Jose C Navarro, Udaya K Ranawaka, Wasim Uddin, Stefano Ricci, John Gommans, Reinhold Schmidt
BACKGROUND: Previous studies have suggested that any benefits of folic acid-based therapy to lower serum homocysteine in prevention of cardiovascular events might be offset by concomitant use of antiplatelet therapy. We aimed to establish whether there is an interaction between antiplatelet therapy and the effects of folic acid-based homocysteine-lowering therapy on major vascular events in patients with stroke or transient ischaemic attack enrolled in the vitamins to prevent stroke (VITATOPS) trial...
June 2012: Lancet Neurology
Yue Huang, Jing Jing, Xing-Quan Zhao, Chun-Xue Wang, Yi-Long Wang, Gai-Fen Liu, Chun-Juan Wang, Li-Ping Liu, Xiao-Meng Yang, Yan Jiao, Yun Jiao, Li-Shi Wang, Yong-Jun Wang, Wei-Kuan Gu
BACKGROUND AND PURPOSE: Elevated plasma C-reactive protein (CRP) has been suggested as a risk factor for ischemic stroke (IS) and coronary ischemic disease. Evidence has shown that high-sensitivity CRP (hs-CRP) is related to a worsening prognosis after IS, but hs-CRP was rare in a large-sample study in a Chinese population. We investigated the associations between hs-CRP and outcome of Chinese patients after acute IS. METHODS: Seven hundred and forty-one consecutive acute IS patients (74...
March 2012: CNS Neuroscience & Therapeutics
Ertuğrul Okuyan, Ahmet Uslu, Mehmet Akif Cakar, Irfan Sahin, Imran Onür, Asım Enhos, Halil Ibrahim Biter, Sükrü Cetin, Mustafa Hakan Dinçkal
OBJECTIVES: Increased homocysteine (HCY) levels are associated with an increased risk of cardiovascular disease. Plasma HCY is increased in chronic heart failure (CHF) patients, and previous studies suggest that hyperhomocysteinemia causes adverse cardiac remodeling and affects pump function. We aimed to evaluate the HCY levels in patients with diastolic heart failure with preserved left ventricular ejection fraction (LVEF). METHODS: We prospectively studied 68 patients (39 females and 29 males) who were hospitalized for symptomatic heart failure, as well as 40 age- and sex-matched healthy subjects who comprised the control group...
2010: Cardiology
Natalia S Rost, Rosanna Rahman, Shruti Sonni, Allison Kanakis, Christi Butler, Efi Massasa, Lisa Cloonan, Aaron Gilson, Pilar Delgado, Yuchiao Chang, Alessandro Biffi, Jordi Jimenez-Conde, Angela Besanger, Gisele Silva, Eric E Smith, Jonathan Rosand, Karen L Furie
BACKGROUND: White matter hyperintensity (WMH) is a common radiographic finding in the aging population and a potent risk factor for symptomatic cerebrovascular disease. It is unclear whether WMH represents a single or multiple biological processes. We sought to investigate the extent and determinants of WMH in patients with acute ischemic stroke (AIS). METHODS: We retrospectively analyzed a prospectively enrolled hospital-based cohort of patients with AIS. WMH volume (WMHV) was measured using a previously published method with high interrater reliability based on a semiautomated image analysis program...
May 2010: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Tânia Corrêa de Toledo Ferraz Alves, Luiz Kobuti Ferreira, Mauricio Wajngarten, Geraldo F Busatto
Vascular risk factors can play an important role in determining the onset of non-genetic Alzheimer's disease (AD). Most cases of AD are sporadic and late-onset, and a complex interaction between genetic predisposition and vascular risk factors has been proposed. Vascular risk factors for AD include stroke, hypertension, diabetes, homocysteine, smoking, hypercholesterolemia, heart failure and atrial fibrillation; it is possible that these can trigger cerebrovascular dysfunction and AD pathology. Explanations for these associations include the coincidence of common disorders in the elderly where vascular and cerebrovascular disease can precipitate AD, implying that the onset of dementia disease is determined by a synergistic combination of risk factors...
2010: Journal of Alzheimer's Disease: JAD
Bruce Ovbiagele, David S Liebeskind, Sandra Pineda, Jeffrey L Saver
OBJECTIVE: To assess the association of proteinuria with the frequency and number of cerebral microbleeds (CMB), a harbinger of future hemorrhagic stroke. DESIGN: Cross-sectional analysis. Patients Patients with consecutive ischemic stroke and transient ischemic attack admitted to a university hospital during a 22-month period. INTERVENTIONS: Presence and number of CMB were evaluated using gradient-echo T2*-weighted magnetic resonance imaging...
January 2010: Archives of Neurology
Claire L Allen, Ulvi Bayraktutan
Stroke is a leading cause of morbidity and mortality in western populations, with up to 40% of survivors not expected to recover independence from severe disabilities. This equates to an immense financial burden on health systems worldwide. Hence further education is required to inform individuals of the risks to promote secondary prevention strategies in future generations. Stroke is a heterogeneous, multifactorial disease regulated by modifiable and nonmodifiable risk factors. Modifiable factors include a history of high blood pressure, diabetes mellitus and coronary heart disease...
May 2008: International Journal of Stroke: Official Journal of the International Stroke Society
Christianna Purnell, Sujuan Gao, Christopher M Callahan, Hugh C Hendrie
OBJECTIVE: The purpose of this study was to conduct a systematic review of the literature of cardiovascular factors pertaining to incident Alzheimer disease (AD). METHODS: A systematic literature review was conducted of all studies of cardiovascular risk factors for incident AD listed in PubMed in English from 2000 to 2007. Risk factors included hypertension, diabetes, exercise, alcohol intake, smoking, B complex vitamins, homocysteine, stroke, atrial fibrillation, apolipoprotein E (APOE), lipids, and diet...
January 2009: Alzheimer Disease and Associated Disorders
Zaldy S Tan, Alexa Beiser, Ramachandran S Vasan, Rhoda Au, Sanford Auerbach, Douglas P Kiel, Philip A Wolf, Sudha Seshadri
BACKGROUND: Clinical hypothyroidism and hyperthyroidism are recognized causes of reversible dementia, but previous studies relating thyrotropin levels to cognitive performance in clinically euthyroid persons have yielded inconsistent results. METHODS: We related serum thyrotropin concentrations measured at baseline (March 1977-November 1979) to the risk of Alzheimer disease (AD) in 1864 cognitively intact, clinically euthyroid Framingham original cohort participants (mean age, 71 years; 59% women)...
July 28, 2008: Archives of Internal Medicine
Amytis Towfighi, Jeffrey L Saver, Rita Engelhardt, Bruce Ovbiagele
BACKGROUND: Data on recent stroke prevalence rates among middle-aged men in the United States indicate that men aged 55 to 64 years are 3 times more likely than men aged 45 to 54 years to have experienced a stroke. We aimed to determine potential risk factors that may contribute to this steep increase in late midlife stroke occurrence. METHODS: We analyzed the National Health and Nutrition Examination Survey 1999 to 2004 data sets, assessing stroke prevalence, predictors of stroke occurrence, and vascular risk factors in men across their midlife years...
July 2008: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Rohit R Das, Sudha Seshadri, Alexa S Beiser, Margaret Kelly-Hayes, Rhoda Au, Jayandra J Himali, Carlos S Kase, Emelia J Benjamin, Joseph F Polak, Christopher J O'Donnell, Mitsuhiro Yoshita, Ralph B D'Agostino, Charles DeCarli, Philip A Wolf
BACKGROUND AND PURPOSE: Previous estimates of the prevalence of silent cerebral infarction (SCI) on MRI in community-based samples have varied between 5.8% and 17.7% depending on age, ethnicity, presence of comorbidities, and imaging techniques. We document the prevalence and risk factors associated with SCI at midlife in the community-based Framingham sample. METHODS: Our study sample comprised 2040 Framingham Offspring (53% female; mean age, 62+/-9 years) who attended the sixth examination (1996-1998), underwent volumetric brain MRI (1999-2005,) and were free of clinical stroke at MRI...
November 2008: Stroke; a Journal of Cerebral Circulation
J David Spence
BACKGROUND: The pathogenesis of stroke is very different from that of myocardial infarction; most strokes are embolic, and as elevated plasma total homocysteine (tHcy) increases thrombosis, it increases the risk of cardioembolic strokes, particularly in atrial fibrillation, as well as the risk of deep vein thrombosis leading to paradoxical embolism, and elevated tHcy also increases strokes from cortical vein thrombosis. PURPOSE AND METHODS: The main study results of the Vitamin Intervention for Stroke Prevention (VISP) trial showed no benefit of vitamin therapy for homocysteine lowering...
2007: Clinical Chemistry and Laboratory Medicine: CCLM
José A Egido
The risk of stroke recurrence is high. With annual rates of around 4%, accumulative rates of 40% are reached within 10 years. Despite being underestimated, the risk is highest in the early stages; around 12% in the first year. The most important etiological subtypes have different levels of risk; the highest being for atherothrombotic infarction and the lowest for lacunar infarction. Each etiology has its own risk factors. For example, in carotid stenosis, the grade of stenosis, ulceration, and plaque morphology, silent infarction on neuroimaging, coexistence of intracranial disease, or microemboli detected on transcranial Doppler, all have predictive value for stroke recurrence...
2005: Cerebrovascular Diseases
Daniela Poli, Emilia Antonucci, Emanuele Cecchi, Rossella Marcucci, Agatina Alessandrello Liotta, Anna Paola Cellai, Meri Lenti, Gian Franco Gensini, Rosanna Abbate, Domenico Prisco
BACKGROUND AND PURPOSE: In patients with atrial fibrillation (AF), oral anticoagulant therapy (OAT) is effective in reducing stroke and embolism. However, despite OAT, ischemic events do occur in some patients. Studies specifically addressing the identification of risk factors for ischemic events during well-conducted OAT are not available. In this study, we prospectively investigated the role of classic risk factors and homocysteine levels in the occurrence of ischemic complications in 364 AF patients on OAT...
October 2005: Stroke; a Journal of Cerebral Circulation
Lorenzo Loffredo, Francesco Violi, Filippo Luca Fimognari, Roberto Cangemi, Pier Sandro Sbrighi, Francesca Sampietro, Giuseppina Mazzola, Vito Nicola Di Lecce, Armando D'Angelo
BACKGROUND AND OBJECTIVES: Atrial fibrillation is complicated by a high rate of ischemic stroke. Previous studies have shown that an increased level of circulating total plasma homocysteine (tHcy) is an independent predictor of stroke, but it is unclear whether it is also predictive of stroke in patients with atrial fibrillation. The objective of this study was to evaluate whether increased tHcy is an independent predictor of cardio-embolic stroke in patients with non-valvular atrial fibrillation...
September 2005: Haematologica
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