{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T22:29:40Z","timestamp":1791930580712,"version":"4.3.4"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>Hyperhomocysteinemia is a well-known risk factor for vascular disease. However, its action, mechanism, and role in the acute phase of stroke have not been determined. We tried to determine whether an association existed between elevated serum homocysteine levels and early neurological deterioration (END) in patients with acute ischemic stroke.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>We performed a secondary analysis from the Cilostazol in Acute Ischemic Stroke Treatment (CAIST) trial, which was a double-blinded, randomized, multicenter trial, assessing the noninferiority of cilostazol over aspirin within 48 hours of an acute ischemic stroke. END was defined as an increase of \u22651 point in motor power or an increase of \u22652 points in the total National Institute of Health Stroke Scale score within 7 days.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>\n              The mean (\u00b1SD) serum homocysteine level was 11.4\u00b14.7 \u03bcmol\/L. Of the 396 patients studied, 57 (14.4%) patients worsened during the 7 days after inclusion. Most (68%) of the END cases occurred within the first 24 hours after treatment. High levels (&gt;10.3 \u03bcmol\/L) of serum homocysteine were independent predictors for END (third quartile odds ratio, 3.45; 95% confidence intervals, 1.25\u20139.50;\n              <jats:italic>P<\/jats:italic>\n              =0.016; fourth quartile odds ratio, 3.36; 95% confidence intervals 1.18\u20139.52;\n              <jats:italic>P<\/jats:italic>\n              =0.023) in multivariate analysis.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Patients with acute stroke with elevated serum homocysteine levels are at an increased risk for END.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.113.004099","type":"journal-article","created":{"date-parts":[[2014,1,22]],"date-time":"2014-01-22T05:02:32Z","timestamp":1390366952000},"page":"871-873","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":153,"title":["Homocysteine as a Predictor of Early Neurological Deterioration in Acute Ischemic Stroke"],"prefix":"10.1161","volume":"45","author":[{"given":"Hyung-Min","family":"Kwon","sequence":"first","affiliation":[{"name":"From the Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea (H.-M.K., Y.-S.L.); Department of Neurology, Seoul National University Bundang Hospital, Seongnam, South Korea (H.-J.B.); and Department of Neurology, Asan Medical Center, Seoul, South Korea (D.-W.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong-Seok","family":"Lee","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea (H.-M.K., Y.-S.L.); Department of Neurology, Seoul National University Bundang Hospital, Seongnam, South Korea (H.-J.B.); and Department of Neurology, Asan Medical Center, Seoul, South Korea (D.-W.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hee-Joon","family":"Bae","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea (H.-M.K., Y.-S.L.); Department of Neurology, Seoul National University Bundang Hospital, Seongnam, South Korea (H.-J.B.); and Department of Neurology, Asan Medical Center, Seoul, South Korea (D.-W.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong-Wha","family":"Kang","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea (H.-M.K., Y.-S.L.); Department of Neurology, Seoul National University Bundang Hospital, Seongnam, South Korea (H.-J.B.); and Department of Neurology, Asan Medical Center, Seoul, South Korea (D.-W.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/nm0496-386"},{"key":"e_1_3_2_3_2","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1160\/TH05-05-0313","article-title":"Homocysteine and thrombosis: from basic science to clinical evidence.","volume":"94","author":"Undas A","year":"2005","unstructured":"Undas A, Brozek J, Szczeklik A. 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Plasma homocyst(e)ine concentrations in cerebrovascular disease. Stroke. 1999;30:2244\u20132245.","journal-title":"Stroke"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.32.1.57"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.113.004099","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T14:34:28Z","timestamp":1715610868000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.113.004099"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,3]]},"references-count":13,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2014,3]]}},"alternative-id":["10.1161\/STROKEAHA.113.004099"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.113.004099","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,3]]},"assertion":[{"value":"2013-11-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-12-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-01-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}