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SYSTEMATIC REVIEW article
Front. Neurol.
Sec. Stroke
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1576453
The Prognostic Value of Homocysteine Levels in Hemorrhagic Stroke Patients: A Systematic Review and Meta-Analysis
Provisionally accepted
Yi Zong1
Qiaohui Gu2*- 1Huzhou Third Municipal Hospital,the Affiliated Hospital of Huzhou University, Huzhou, China
- 2Huzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Huzhou, China
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Background: Hemorrhagic stroke is associated with significant morbidity and mortality, prompting the search for modifiable risk factors and prognostic indicators. Elevated homocysteine levels have been implicated in vascular diseases, but their link to hemorrhagic stroke outcomes remains unclear. This systematic review and meta-analysis aimed to evaluate the association between homocysteine levels and outcomes in hemorrhagic stroke patients.The MEDLINE, EMBASE, and Cochrane Central databases were searched for studies comparing the outcomes of hemorrhagic stroke in patients with high versus normal homocysteine levels. Data were pooled using random-effects models to calculate odds ratios (ORs) for mortality and poor functional outcomes and standardized mean differences (SMDs) for homocysteine levels, with respective 95% confidence intervals (CIs).The review included 10 studies. Pooled analysis showed no significant association between high homocysteine levels and increased risk of mortality (OR: 1.123, 95% CI: 0.589 to 2.143), poor functional outcomes (OR: 1.203, 95% CI: 0.962 to 1.504), or unfavorable neurological outcomes (OR: 1.001, 95% CI: 0.618 to 1.620). Substantial heterogeneity was observed among studies.High homocysteine levels were not significantly associated with mortality, functional outcomes, or unfavorable neurological outcomes in hemorrhagic stroke patients.The clinical utility of homocysteine as a prognostic marker in this population remains uncertain and warrants further research.
Keywords: hemorrhagic stroke, Homocysteine, Meta-analysis, prognosis, Systematic reveiw
Received: 14 Feb 2025; Accepted: 11 Apr 2025.
Copyright: © 2025 Zong and Gu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Qiaohui Gu, Huzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Huzhou, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.