Evidence map›Paper›PMID 26199315›Full record

ArticleStroke2015

Elevated Total Homocysteine Levels in Acute Ischemic Stroke Are Associated With Long-Term Mortality.

Zhihong Shi, Yalin Guan, Ya Ruth Huo, Shuling Liu, Meilin Zhang, Hui Lu, Wei Yue, Jinhuan Wang, Yong Ji

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Stroke, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 69 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
69citing papers in PubMed, 5 pooled it
11.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

69 citing papers in PubMed, 5 syntheses or guidelines pooled it, 126 citations in OpenAlex.

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  15. Atherogenic Effect of Homocysteine, a Biomarker of Inflammation and Its Treatment.The International journal of angiology : official publication of the International College of Angiology, Inc · 2024
    Review
  16. Folate, Homocysteine, and Adverse Outcomes After Ischemic Stroke.Journal of the American Heart Association · 2024
    Article
  17. Article
  18. Article
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9 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Zhihong ShiFrom the Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases (Z.S., Y.G., S.L., H.L., W.Y., J.W., Y.J.), Department of Neurology (Z.S., Y.G., S.L., H.L., W.Y., Y.J.), and Department of Neurosurgery (J.W.), Tianjin Huanhu Hospital, Tianjin, China; School of Medicine, University of New South Wales, Kensington, NSW, Australia (Y.R.H.); and Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China (M.Z.).
Yalin GuanFrom the Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases (Z.S., Y.G., S.L., H.L., W.Y., J.W., Y.J.), Department of Neurology (Z.S., Y.G., S.L., H.L., W.Y., Y.J.), and Department of Neurosurgery (J.W.), Tianjin Huanhu Hospital, Tianjin, China; School of Medicine, University of New South Wales, Kensington, NSW, Australia (Y.R.H.); and Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China (M.Z.).
Ya Ruth HuoFrom the Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases (Z.S., Y.G., S.L., H.L., W.Y., J.W., Y.J.), Department of Neurology (Z.S., Y.G., S.L., H.L., W.Y., Y.J.), and Department of Neurosurgery (J.W.), Tianjin Huanhu Hospital, Tianjin, China; School of Medicine, University of New South Wales, Kensington, NSW, Australia (Y.R.H.); and Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China (M.Z.).
Shuling LiuFrom the Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases (Z.S., Y.G., S.L., H.L., W.Y., J.W., Y.J.), Department of Neurology (Z.S., Y.G., S.L., H.L., W.Y., Y.J.), and Department of Neurosurgery (J.W.), Tianjin Huanhu Hospital, Tianjin, China; School of Medicine, University of New South Wales, Kensington, NSW, Australia (Y.R.H.); and Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China (M.Z.).
Meilin ZhangFrom the Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases (Z.S., Y.G., S.L., H.L., W.Y., J.W., Y.J.), Department of Neurology (Z.S., Y.G., S.L., H.L., W.Y., Y.J.), and Department of Neurosurgery (J.W.), Tianjin Huanhu Hospital, Tianjin, China; School of Medicine, University of New South Wales, Kensington, NSW, Australia (Y.R.H.); and Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China (M.Z.).
Hui LuFrom the Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases (Z.S., Y.G., S.L., H.L., W.Y., J.W., Y.J.), Department of Neurology (Z.S., Y.G., S.L., H.L., W.Y., Y.J.), and Department of Neurosurgery (J.W.), Tianjin Huanhu Hospital, Tianjin, China; School of Medicine, University of New South Wales, Kensington, NSW, Australia (Y.R.H.); and Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China (M.Z.).
Wei YueFrom the Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases (Z.S., Y.G., S.L., H.L., W.Y., J.W., Y.J.), Department of Neurology (Z.S., Y.G., S.L., H.L., W.Y., Y.J.), and Department of Neurosurgery (J.W.), Tianjin Huanhu Hospital, Tianjin, China; School of Medicine, University of New South Wales, Kensington, NSW, Australia (Y.R.H.); and Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China (M.Z.).
Jinhuan WangFrom the Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases (Z.S., Y.G., S.L., H.L., W.Y., J.W., Y.J.), Department of Neurology (Z.S., Y.G., S.L., H.L., W.Y., Y.J.), and Department of Neurosurgery (J.W.), Tianjin Huanhu Hospital, Tianjin, China; School of Medicine, University of New South Wales, Kensington, NSW, Australia (Y.R.H.); and Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China (M.Z.).
Yong JiFrom the Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases (Z.S., Y.G., S.L., H.L., W.Y., J.W., Y.J.), Department of Neurology (Z.S., Y.G., S.L., H.L., W.Y., Y.J.), and Department of Neurosurgery (J.W.), Tianjin Huanhu Hospital, Tianjin, China; School of Medicine, University of New South Wales, Kensington, NSW, Australia (Y.R.H.); and Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China (M.Z.). jiyongusa@126.com.
UNSW Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeTotal homocysteine (tHcy) levels are associated with secondary vascular events and mortality after stroke. The aim of this study was to investigate whether tHcy levels in the acute phase of a stroke contribute to the recurrence of cerebro-cardiovascular events and mortality.

methodsA total of 3799 patients were recruited after hospital admission for acute ischemic stroke. Levels of tHcy were measured within 24 hours after primary admission. Patients were followed for a median of 48 months.

resultsDuring the follow-up period, 233 (6.1%) patients died. After adjustment for age, smoking status, diabetes mellitus, and other cardiovascular risk factors, patients in the highest tHcy quartile (>18.6 μmol/L) had a 1.61-fold increased risk of death (adjusted hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.03-2.53) compared with patients in the lowest quartile (≤10 μmol/L). Further subgroup analysis showed that this correlation was only significant in the large-artery atherosclerosis stroke subtype (adjusted HR, 1.80; 95% CI, 1.05-3.07); this correlation was not significant in the small-vessel occlusion subtype (adjusted HR, 0.80; 95% CI, 0.30-2.12). The risk of stroke-related mortality was 2.27-fold higher for patients in the third tHcy quartile (adjusted HR, 2.27; 95% CI, 1.06-4.86) and 2.15-fold more likely for patients in the fourth quartile (adjusted HR, 2.15; 95% CI, 1.01-4.63) than for patients in the lowest tHcy quartile. The risk of cardiovascular-related mortality and the risk of recurrent ischemic stroke were not associated with tHcy levels.

conclusionsOur findings suggest that elevated tHcy levels in the acute phase of an ischemic stroke can predict mortality, especially in stroke patients with the large-vessel atherosclerosis subtype.

Indexed as

AgedBrain IschemiaFemaleFollow-Up StudiesHomocysteineHumansMaleMiddle AgedPrognosisRecurrenceStrokeHomocysteineacute ischemic strokeatherosclerosishomocysteinelong-term mortalitystroke

Identifiers

PMID26199315
PMCPMC4542568
OpenAlexW1959227492

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.