Correlation Between Plasma Homocysteine And Intracranialarterial Plaque Stability

Background: Previously limited to intracranial arterial imaging techniques,researches about plasma homocysteine and intracranial atherosclerotic plaques have been relatively rare.The purpose of the study was to investigate the correlation between plasma homocysteine(Hcy)levels and intracranial artery plaque stability.Subject and method: From May 2016 to September 2017,94 patients with intracranial atherosclerosis(ICAS)of Jiangsu Provincial People's Hospital were retrospectively enrolled.The plasma Hcy levels were measured and the intracranial plaque enhancement grades were assessed on high-resolution magnetic resonance imaging(HR-MRI).The patients were divided into two groups(symptomatic group and asymptomatic group)based on the clinical information and diffusion weighted imaging(DWI).Plaque enhancement grades,Hcy levels,patient demographics(age,sex)and atherosclerotic risk factors were compared using a Student's test or a Pearson's chi-square test.Correlation of Hcy levels with plaque enhancement grades were examined by Spearman correlation analysis.Multivariable logistic regression was constructed to evaluate the association between high Hcy levels and plaque enhancement grades,while adjusting for demographics and traditional atherosclerotic risk factors.The ROC curve was drawn and the diagnostic parameters of the area under the curve(AUC)were used to evaluate the plaque enhancement grade and the diagnostic value of Hcy for acute ischemic stroke.Results: Hcy levels(P=0.001)and plaque enhancement grades(P <0.001)showed statistically significant differences between symptomatic group(n=75)and asymptomatic group(n=19).Strong plaque enhancement was significantly correlated with high Hcy(r = 0.408,P <0.001).High Hcy was found to be associated with strong plaque enhancement independently of age,sex and other traditional atherosclerotic risk factors(P< 0.001,OR 6.31,95% CI 2.47-16.12).The combination of them strengthened the ability to stratify the likelihood for ischemic stroke,with an improved area under the receiver operating characteristic curve(AUC)of 0.871,significantly higher than that of strong plaque enhancement(0.755)and high Hcy level(0.715)alone(P < 0.05 for both).Conclusion: Hyperhomocysteine is an independent predictor for the evaluation of intracranial unstable plaques.The combined assessment of plasma Hcy levels and plaque enhancement may improve ischemic stroke risk stratification.