| Title | Association between percent decline in serum total homocysteine and risk of first stroke |
| Authors | Huang, Xiao Li, Youbao Li, Ping Li, Jianping Bao, Huihui Zhang, Yan Wang, Binyan Sun, Ningling Wang, Jiguang He, Mingli Yin, Delu Tang, Genfu Chen, Yundai Cui, Yiming Huang, Yining Hou, Fan Fan Qin, Xianhui Huo, Yong Cheng, Xiaoshu |
| Affiliation | Nanchang Univ, Affiliated Hosp 2, Dept Cardiol, Nanchang, Jiangxi, Peoples R China. Southern Med Univ, Nanfang Hosp, Div Nephrol, Guangzhou, Guangdong, Peoples R China. Peking Univ, Hosp 1, Natl Clin Res Ctr Kidney Dis, Beijing, Peoples R China. Peking Univ, Hosp 1, State Key Lab Organ Failure Res, Beijing, Peoples R China. Peking Univ, Hosp 1, Guangdong Prov Inst Nephrol, Beijing, Peoples R China. Peking Univ, Hosp 1, Dept Cardiol, Beijing, Peoples R China. Peking Univ, Hosp 1, Dept Pharm, Beijing, Peoples R China. Peking Univ, Hosp 1, Dept Neurol, Beijing, Peoples R China. Peking Univ, Peoples Hosp, Dept Cardiol, Beijing, Peoples R China. Ruijin Hosp, Ctr Epidemiol Studies & Clin Trials, Shanghai Inst Hypertens, Dept Hypertens, Shanghai, Peoples R China. First Peoples Hosp, Dept Neurol, Lianyungang, Peoples R China. First Peoples Hosp, Dept Cardiol, Lianyungang, Peoples R China. Anhui Med Univ, Inst Biomed, Hefei, Anhui, Peoples R China. Anhui Med Univ, Sch Hlth Adm, Hefei, Anhui, Peoples R China. Chinese Peoples Liberat Army Gen Hosp, Dept Cardiol, Beijing, Peoples R China. Nanchang Univ, Affiliated Hosp 2, Dept Cardiol, Nanchang, Jiangxi, Peoples R China. Qin, XH (reprint author), Southern Med Univ, Nanfang Hosp, Div Nephrol, Guangzhou, Guangdong, Peoples R China. Qin, XH (reprint author), Peking Univ, Hosp 1, Natl Clin Res Ctr Kidney Dis, Beijing, Peoples R China. Qin, XH (reprint author), Peking Univ, Hosp 1, State Key Lab Organ Failure Res, Beijing, Peoples R China. Qin, XH (reprint author), Peking Univ, Hosp 1, Guangdong Prov Inst Nephrol, Beijing, Peoples R China. Huo, Y (reprint author), Peking Univ, Hosp 1, Dept Cardiol, Beijing, Peoples R China. |
| Keywords | FOLIC-ACID SUPPLEMENTATION RANDOMIZED CONTROLLED-TRIALS CARDIOVASCULAR-DISEASE PREVENTION LOWERING THERAPY ISCHEMIC-STROKE METAANALYSIS EFFICACY HYPERTENSION MECHANISMS INSIGHT |
| Issue Date | 2017 |
| Publisher | NEUROLOGY |
| Citation | NEUROLOGY. 2017, 89(20), 2101-2107. |
| Abstract | Objective: To examine whether a change in serum total homocysteine (tHcy) levels is associated with first stroke risk in a post hoc analysis of the China Stroke Primary Prevention Trial (CSPPT). Methods: We analyzed 16,867 participants of the CSPPT with tHcy measurements at both baseline and exit visits. The primary outcome was first stroke. The secondary outcome was a composite of cardiovascular events consisting of cardiovascular death, myocardial infarction, and stroke. The percent decline in tHcy was calculated as [(baseline tHcy 2 exit tHcy)/baseline tHcy x 100]. Results: Over the median treatment duration of 4.5 years, participants who developed a first stroke had a significantly lower percent decline in tHcy (beta = -5.7; 95% confidence interval [CI] -8.8 to -2.6) compared to their counterparts. A 20% tHcy decline was associated with a reduction in stroke risk of 7% (hazard ratio [HR] 0.93; 95% CI 0.90-0.97). When percent decline in tHcy was assessed as tertiles, a significantly lower stroke risk was found in those in tertiles 2-3 (HR 0.79; 95% CI 0.64-0.97) compared with participants in tertile 1. Similar results were observed for the composite of cardiovascular events. The beneficial effect associated with greater tHcy reduction was observed across strata for age, sex, treatment group (with vs without folic acid), MTHFR C677T genotypes, baseline tHcy and serum folate levels, and blood pressure control. Conclusions: Percent lowering in tHcy was significantly associated with a reduction in first stroke risk in Chinese adults with hypertension, and if further confirmed, may serve as a useful indicator for folic acid treatment efficacy on stroke prevention. |
| URI | http://hdl.handle.net/20.500.11897/500852 |
| ISSN | 0028-3878 |
| DOI | 10.1212/WNL.0000000000004648 |
| Indexed | SCI(E) PubMed Medline |
| Appears in Collections: | 第一医院 人民医院 |
