Lowering Homocysteine in Patients With Ischemic Stroke to Prevent Recurrent Stroke, Myocardial Infarction, and Death

Abstract

Homocystinuria, a rare condition in which plasma levels of total homocysteine are very high, was first associated with cerebrovascular disease in 1962.^1,2 In 1969, McCully³ suggested that more moderate levels of hyperhomocystinemia might be associated with atherosclerosis. Case-control studies have shown higher levels of total homocysteine in patients with premature peripheral and cerebrovascular disease and atherosclerosis.^4,5 Most but not all studies have demonstrated an association between elevated levels of total homocysteine and stroke.^6-11