Homocysteine and lipoprotein (a) correlation in ischemic stroke patients

Background: Homocysteine and Lipoprotein (a) have been recognized as risk factors for coronary heart disease. However, their role in ischemic stroke is still not defined. Therefore the present study was undertaken to evaluate their levels and relationship in patients of ischemic stroke. Methods: The study was conducted in consecutive patients admitted with a diagnosis of acute ischaemic stroke and age and sex matched healthy controls. Plasma homocysteine and serum I lipoprotein (a) levels were determined in the fasting venous blood samples using ELISA and immunoturbidimetric assay respectively. Results: 66 patients with ischaemic stroke (30 males, 36 females) of mean age 54.43 +/- 1.97 years and 72 controls (39 males, 33 females) of mean age 53.86 +/- 1.88 years were studied. Mean plasma homocysteine levels in the stroke patients and control groups were 28.40 +/- 2.08 pmol/L and 11.16 +/- 1.09 pmol/L respectively (p<0.001). Odds ratio for raised homocysteine levels in stroke cases was 15.7. Plasma homocysteine levels showed a positive correlation with smoking (Pearson's correlation coefficient = 0.324 and p-value of 0.008), (Odds ratio = 5.71). Serum Lipoprotein (a) levels in stroke cases and control group were 57.33 +/- 4.40 mg/dl and 23.46 +/- 1.09 mg/dl respectively, (p<0.001), (Odds Ratio=8.62). A positive correlation was also observed between Homocysteine and Lipoprotein (a) levels with Pearson's correlation coefficient of 0.75 and p-value<0.001. Conclusions: Raised homocysteine and serum lipoprotein (a) levels were found to be independently associated with ischemic stroke with a significant positive correlation between the two parameters. Elevated homocysteine levels may modulate the toxicity of lipoprotein (a) in ischemic stroke. (C) 2009 Elsevier B.V. All rights reserved.