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Homocysteine Level Predicts Response to Dual Antiplatelet in Women with Minor Stroke or Transient Ischemic Attack: Sub-analysis of the CHANCE Trial
First author：Jiejie Li
Corresponding author：Yongjun Wang
essential_information
2020-03-20
Published articles
Journal：Arterioscler Thromb Vasc Biol
Publication type: Article
IF(IF): 6.62
PMID: 31941381 Link To Pubmed Full text Download
Background And Purpose
Homocysteine (Hcy) is a well known risk factor for initial and recurrent stroke. A casual link has even been suggested between Hcy and stroke from Mendelian randomization. Moreover, a body of evidence from experimental studies revealed that hyperhomocysteinemia caused platelet activation, endothelium dysfunction, oxidative stress, chronic inflammation, and as a consequence, inadequate platelet inhibition, consistent with the clinical findings that the patients with elevated Hcy levels were less sensitive to antiplatelet therapy. On the other hand, estrogen modulated Hcy levels, leading to a different distribution of Hcy levels between women and men.Nevertheless, it is still unknown whether there is a gender difference for using Hcy to predict patients’ response to antiplatelet therapy after stroke. This study aimed to investigate the relationship of homocysteine (Hcy) levels with the efficacy and safety of dual antiplatelet therapy in female and male patients.
Method
Cox proportional-hazards models
Conclusion
Homocysteine could be a potential biomarker to discriminate the effects of dual and single antiplatelet therapy in female patients with minor ischemic stroke or high-risk transient ischemic attack