Elevated plasma homocyst(e)ine concentration as a possible independent risk factor for stroke

Bruce M Coull, M. Rene Malinow, Nancy Beamer, Gary Sexton, Frank Nordt, Pat De Garmo

Research output: Contribution to journalArticle

279 Scopus citations


Homocyst(e)ine refers to the sulfur-containing amino acids homocysteine, homocystine, and homocysteine-cysteine mixed disulfide, which normally exist in plasma in both the free and protein-bound forms. Marked hyperhomocyst(e)inemia is associated with well-recognized complications of occlusive thrombotic events and a characteristic syndrome. It is less clear whether mild to moderate elevations in plasma homocyst(e)ine concentrations (i.e., 1.5-5-fold increases) also represent a risk factor for stroke and, if so, whether it is independent of other recognized risk factors. To examine these questions we compared the plasma homocyst(e)ine levels in 41 patients with acute strokes, 27 patients with transient ischemic attacks, 31 patients with recognized risk factors for but no recent symptoms of cerebrovascular disease, and 31 normal volunteers (controls). Plasma homocyst(e)ine concentration was moderately but significantly higher in the patients than in the controls (p<0.0001). Approximately 30% of the patients had homocyst(e)ine levels higher than the controls. No relation was found between homocyst(e)ine concentration and other recognized stroke risk factors or stroke type; however, a positive correlation was found between serum uric acid and plasma homocyst(e)ine levels. These data suggest that a moderately elevated plasma homocyst(e)ine concentration may be an independent risk factor for cerebrovascular disease.

Original languageEnglish (US)
Pages (from-to)572-576
Number of pages5
Issue number4
Publication statusPublished - Apr 1990
Externally publishedYes



  • Cerebral infarction
  • Homocysteine
  • Risk factors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

Cite this

Coull, B. M., Malinow, M. R., Beamer, N., Sexton, G., Nordt, F., & De Garmo, P. (1990). Elevated plasma homocyst(e)ine concentration as a possible independent risk factor for stroke. Stroke, 21(4), 572-576.