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Association of Severity and Prognosis With Elevated Homocysteine Levels in Patients With Intracerebral Hemorrhage.

ABSTRACT: Background: Intracerebral hemorrhage (ICH) has high mortality and morbidity rates in the world. Homocysteine (Hcy) has been demonstrated to be an independent risk factor and could predict the prognosis and recurrence of ischemic stroke. In our study, we aimed to find out the relationship between Hcy levels and the severity and prognosis of patients with ICH. Methods: Patients' basic characteristics and laboratory examination results, including the concentration of homocysteine, were taken at baseline from January 2014 to September 2016, and a 1 year follow-up, including the modified Rankin Scale and living status, was taken for all the patients. Logistic regression and Kaplan-Meier survival method were used to analyze the relationship between different Hcy levels and clinical outcome. Results: A total of 551 patients with acute ICH from 13 hospitals in Beijing were enrolled in our study. High Hcy was detected in 284 patients (51.5%). Percentage of male, smoking, drinking, and concentration of hemoglobin A1c and triglyceride levels showed a significant difference between different Hcy level groups (all P-values <0.05). In the logistic regression analysis, high Hcy level is an independent risk factor for the prevalence of 3 month poor prognosis [odd ratio (95% confidence interval) = 1.601 (1.063-2.412), P = 0.0242], especially in female subgroup. In the 1 year follow-up period, high Hcy level patients had a significantly higher rate of fatal incidence compared to normal Hcy level patients (P = 0.0023). Conclusions: High Hcy level was independently associated with poorer 3 month prognosis and a lower survival rate within 1 year in patients with ICH.

SUBMITTER: Wang D

PROVIDER: S-EPMC7604273 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Association of Severity and Prognosis With Elevated Homocysteine Levels in Patients With Intracerebral Hemorrhage.

Wang Dandan D Wang Wenjuan W Wang Anxin A Zhao Xingquan X

Frontiers in neurology 20201019

<b>Background:</b> Intracerebral hemorrhage (ICH) has high mortality and morbidity rates in the world. Homocysteine (Hcy) has been demonstrated to be an independent risk factor and could predict the prognosis and recurrence of ischemic stroke. In our study, we aimed to find out the relationship between Hcy levels and the severity and prognosis of patients with ICH. <b>Methods:</b> Patients' basic characteristics and laboratory examination results, including the concentration of homocysteine, wer ...[more]

PMID: 33193018

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Project description:Background: Over the past decade, many studies have reported the association of brain natriuretic peptide (BNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) with clinical outcome of intracerebral hemorrhage (ICH). However, a broad consensus has not been reached. Objective: To evaluate the role of BNP/NT-proBNP levels in prognosis and disease severity assessment in patients with ICH. Methods: A systematic literature search was conducted utilizing PubMed, Embase, Web of Science and the Cochrane Library databases up to July 23, 2021. Studies that explored the association between BNP/NT-proBNP level and clinical outcome or disease severity in ICH patients were eligible. Outcome measures were all-cause mortality, poor functional outcome, adverse cardiac events and markers of disease severity. Results: Ten studies, involving 1,373 patients with ICH, met the inclusion criteria. Nine studies focused on clinical outcomes (five all-cause mortality, five functional outcomes, and one adverse cardiac event) and seven on disease severity. In terms of prognosis, all five studies showed an association between elevated BNP/NT-proBNP level and increased risk of all-cause mortality in ICH patients. Four of the five studies reported poor functional outcomes in patients with higher BNP/NT-proBNP levels and one study associated higher BNP/NT-proBNP levels with increased risk of adverse cardiac events. Moreover, two studies identified an additional predictive ability of BNP/NT-proBNP level beyond that of pre-existing prognostic variables. In terms of disease severity, five studies (71%) reported that BNP/NT-proBNP level correlated positively with hematoma volume in addition to ICH and GCS scores. Conclusion: Elevated BNP/NT-proBNP level is associated with increased risk of all-cause mortality, poor functional outcome, adverse cardiac events and disease severity in patients with ICH. Thus, BNP/NT-proBNP level is a promising prognostic indicator for ICH and also an effective marker of disease severity. Current evidence remains limited by the small number and high heterogeneity of included studies. Further appropriately designed, large-scale studies are required to confirm the current findings.

Dataset Information

Association of Severity and Prognosis With Elevated Homocysteine Levels in Patients With Intracerebral Hemorrhage.

Publications

Association of Severity and Prognosis With Elevated Homocysteine Levels in Patients With Intracerebral Hemorrhage.

Similar Datasets

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