The Role of Hyperhomocysteinemia to the Development of Pathogenetic Variants of Ischemic Strokes: Cohort Study

AIM. To study the effect of hyperhomocysteinemia in combination with and without hypercholesterolemia on the development of various pathogenetic variants of ischemic stroke. MATERIALS AND METHODS. The study included 80 patients (33 with normohomocysteinemia, 47 with hyperhomocysteinemia), with an average age of 70.8 ± 10.9 years, who had suffered ischemic stroke of various etiologies according to TOAST with a verified CT focus. Laboratory parameters (total blood count, lipid spectrum, homocysteine concentration), clinical parameters (muscle strength, speech function, swallowing), clinical scales (SHRM, NIHSS) were evaluated. RESULTS AND DISCUSSION. An increase in homocysteine levels demonstrated a weak positive relationship with the values of CPM (r = 0.24) and NIHSS (r = 0.25); a moderate negative relationship with muscle strength in the affected arm (r = -0.42) and leg (r = -0.34); a moderate positive relationship with the size of the infarction focus (r = 0.50). The group with hyperhomocysteinemia, in contrast to the second, significantly showed a more pronounced volume of the infarction focus and impaired muscle strength in the affected arm, p < 0.05. No reliable data were found for the contribution of homocysteine to the heterogeneity of ischemic strokes. CONCLUSION. The results of the study show the contribution of a high concentration of homocysteine to the severity of paresis of the affected limbs and the size of the stroke site, but at the same time do not determine the pathogenetic heterogeneity of ischemic stroke.