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Pezzini, Alessandro; Del Zotto, Elisabetta; Archetti, Silvana; Negrini, Riccardo; Bani, Paolo; Albertini, Alberto; Grassi, Mario; Assanelli, Deodato; Gasparotti, Roberto; Vignolo, Luigi Amedeo; Magoni, Mauro; Padovani, Alessandro

Plasma Homocysteine Concentration, C677T MTHFR Genotype, and 844ins68bp CBS Genotype in Young Adults With Spontaneous Cervical Artery Dissection and Atherothrombotic Stroke

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  • Medientyp: E-Artikel
  • Titel: Plasma Homocysteine Concentration, C677T MTHFR Genotype, and 844ins68bp CBS Genotype in Young Adults With Spontaneous Cervical Artery Dissection and Atherothrombotic Stroke
  • Beteiligte: Pezzini, Alessandro; Del Zotto, Elisabetta; Archetti, Silvana; Negrini, Riccardo; Bani, Paolo; Albertini, Alberto; Grassi, Mario; Assanelli, Deodato; Gasparotti, Roberto; Vignolo, Luigi Amedeo; Magoni, Mauro; Padovani, Alessandro
  • Erschienen: Ovid Technologies (Wolters Kluwer Health), 2002
  • Erschienen in: Stroke
  • Sprache: Englisch
  • DOI: 10.1161/hs0302.103625
  • ISSN: 1524-4628; 0039-2499
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:p> <jats:bold> <jats:italic> <jats:bold> <jats:italic>Background and Purpose</jats:italic> </jats:bold> — </jats:italic> </jats:bold> The role of mild hyperhomocysteinemia as a risk factor for cerebral ischemia may depend on stroke subtype. To test this hypothesis, we undertook a prospective case-control study of a group of patients with spontaneous cervical artery dissection (sCAD), a group of patients with atherothrombotic stroke (non-CAD), and a group of control subjects. </jats:p> <jats:p> <jats:bold> <jats:italic> <jats:bold> <jats:italic>Methods</jats:italic> </jats:bold> — </jats:italic> </jats:bold> Fasting total plasma homocysteine (tHcy) concentration, C677T <jats:italic>MTHFR</jats:italic> genotype, and 844ins68bp <jats:italic>CBS</jats:italic> genotype were determined in 25 patients with sCAD, 31 patients &lt;45 years of age with non-CAD ischemic stroke, and 36 control subjects. Biochemical data in the patient groups were obtained within the first 72 hours of stroke onset. </jats:p> <jats:p> <jats:bold> <jats:italic> <jats:bold> <jats:italic>Results</jats:italic> </jats:bold> — </jats:italic> </jats:bold> Median tHcy levels were significantly higher in patients with sCAD (13.2 μmol/L; range, 7 to 32.8 μmol/L) compared with control subjects (8.9 μmol/L; range, 5 to 17.3 μmol/L; 95% CI, 1.05 to 1.52; <jats:italic>P</jats:italic> =0.006). Cases with tHcy concentration above the cutoff level of 12 μmol/L were significantly more represented in the group of patients with sCAD compared with control subjects (64% versus 13.9%; 95% CI, 2.25 to 44.23; <jats:italic>P</jats:italic> =0.003); a significant association between the <jats:italic>MTHFR TT</jats:italic> genotype and sCAD was also observed (36% versus 11.1%; 95% CI, 1.10 to 19.23; <jats:italic>P</jats:italic> =0.045). No significant difference in tHcy levels and in the prevalence of thermolabile <jats:italic>MTHFR</jats:italic> was found between patients with non-CAD ischemic stroke and control subjects and between patients with sCAD and non-CAD ischemic stroke. The distribution of the 844ins68bp <jats:italic>CBS</jats:italic> genotype and the prevalence of subjects carrying both the <jats:italic>TT MTHFR</jats:italic> and 844ins68bp <jats:italic>CBS</jats:italic> genotypes were not significantly different among the 3 groups. </jats:p> <jats:p> <jats:bold> <jats:italic> <jats:bold> <jats:italic>Conclusions</jats:italic> </jats:bold> — </jats:italic> </jats:bold> Our results are consistent with the hypothesis that increased plasma homocysteine levels and the <jats:italic>TT MTHFR</jats:italic> genotype may represent risk factors for sCAD. In contrast, their role in atherothrombotic strokes remains a contentious issue. </jats:p>
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