Wei Dai1, Dongye Li2, Ying Cai3, Enchao Qiu4, Jingwei Xu4, Jing Li4, Yunxia Wang4, Yueqi Guo4, Yifan Li4, Bo Jiang4, Yunyan Zhang4, Junling Ge4, Cunshan Yao4, Runhua Zhang5, Gaifen Liu5, Guoen Yao6, Jianming Cai7, Xihai Zhao8. 1. Department of Neurology, Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China; Department of Neurology, Chinese PLA General Hospital & Medical School of Chinese PLA, Beijing 100853, China. 2. Center for Brain Disorders Research, Capital Medical University and Beijing Institute for Brain Disorders, Beijing 100069, China. 3. Department of Radiology, Taizhou People's Hospital, Taizhou 225300, China. 4. Department of Neurology, Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China. 5. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China. 6. Department of Neurology, Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China. Electronic address: yaoguoensdy@sina.com. 7. Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China. 8. Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing 100084, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing 100069, China. Electronic address: xihaizhao@tsinghua.edu.cn.
Abstract
BACKGROUND: Atherosclerosis in stroke-related vascular beds is the major cause of stroke. Studies demonstrated that multivascular atherosclerosis is prevalent in stroke patients and those with multivascular plaques had higher risk of recurrent stroke. OBJECTIVES: This study investigated the relationship between homocysteine and multivascular atherosclerosis in stroke-related vascular beds using magnetic resonance imaging. METHODS: Patients with recent ischemic cerebrovascular symptoms were enrolled and underwent three-dimensional magnetic resonance vessel wall imaging for intracranial arteries, extracranial carotid arteries and aortic arch. Traditional risk factors and homocysteine were measured. Presence of multivascular plaques defined as plaques in at least two stroke-related vascular beds on magnetic resonance imaging was determined. The relationship between homocysteine and characteristics of multivascular plaques was determined. RESULTS: Of 49 enrolled patients (mean age: 56.3 ± 13.8 years; 35 males), 23 had multivascular plaques. Homocysteine (odds ratio, 1.17; 95% confidence interval, 1.02-1.34; p = 0.022) and age (odds ratio, 1.71; 95% confidence interval, 1.22-2.41; p = 0.002) were significantly associated with presence of multivascular plaques. The adjusted associations remained significant (both p < 0.05). In discriminating presence of multivascular plaques, the area-under-the-curve of age, homocysteine and combination of them was 0.79, 0.70 and 0.87 respectively. CONCLUSIONS: Homocysteine is independently associated with stroke-related multivascular plaques and combination of age and homocysteine has stronger predictive value.
BACKGROUND:Atherosclerosis in stroke-related vascular beds is the major cause of stroke. Studies demonstrated that multivascular atherosclerosis is prevalent in strokepatients and those with multivascular plaques had higher risk of recurrent stroke. OBJECTIVES: This study investigated the relationship between homocysteine and multivascular atherosclerosis in stroke-related vascular beds using magnetic resonance imaging. METHODS:Patients with recent ischemic cerebrovascular symptoms were enrolled and underwent three-dimensional magnetic resonance vessel wall imaging for intracranial arteries, extracranial carotid arteries and aortic arch. Traditional risk factors and homocysteine were measured. Presence of multivascular plaques defined as plaques in at least two stroke-related vascular beds on magnetic resonance imaging was determined. The relationship between homocysteine and characteristics of multivascular plaques was determined. RESULTS: Of 49 enrolled patients (mean age: 56.3 ± 13.8 years; 35 males), 23 had multivascular plaques. Homocysteine (odds ratio, 1.17; 95% confidence interval, 1.02-1.34; p = 0.022) and age (odds ratio, 1.71; 95% confidence interval, 1.22-2.41; p = 0.002) were significantly associated with presence of multivascular plaques. The adjusted associations remained significant (both p < 0.05). In discriminating presence of multivascular plaques, the area-under-the-curve of age, homocysteine and combination of them was 0.79, 0.70 and 0.87 respectively. CONCLUSIONS:Homocysteine is independently associated with stroke-related multivascular plaques and combination of age and homocysteine has stronger predictive value.