RESUMEN
Background and purpose-Elevated plasma homocysteine [Hcy] has considered a causal risk factor for atherosclerosis and has been associated with an increased risk of stroke. We measured fasting plasma Hcy concentrations in the acute phase of ischemic stroke and in the convalescent phase to determine the changes in its level. Methods-Plasma Hcy concentrations were measured in the acute phase [on the 3rd day] in 20 first-ever stroke patients [11 females and 9 males] with age between 52 and 80 years and in 6 subjects serving as controls [4 females and 2 males] with age between 55 and 74 years with re-evaluation of Hey level after 2 months for both groups. Plasma Hcy concentrations were measured by direct chemiluminescence technology. Results-The patient and control groups did not differ significantly in mean Hcy level at the acute stage: 12.02 [range, 9.9 to 13.7 umol/L] versus 10.95 [range, 8.7 to 12.2 umol/L] respectively [p > 0.05]. With highly significant difference on re-evaluation of both groups 2 months later: 15.13 [range, 11.2 to 17.6 umol/L] for patient group and 11.4 [range, 9.4 to 12.6 umol/L] for control group [p < 0.001]. Conclusion-Homocysteine concentrations are not elevated in the acute phase of ischemic stroke but rise in the convalescent phase. These data do not support the hypothesis that raised plasma Hcy concentrations predate the onset of stroke. Instead, they suggest that elevated Hcy levels may be caused by the disease process itself and so evaluation of plasma Hey after stroke represents a secondary marker of risk in survivors