European Journal of Cardiovascular Medicine

Background: India has been experiencing significant demographic, economic and epidemiological transition during the past two decades. The young patients are increasingly affected by stroke, because of both the changing population exposures to risk factors and most tragically, not being able to afford the high cost for stroke care. Age specific incidence of stroke increases progressively with increasing age. Apart from the traditionally recognized risk factors for ischemic stroke (IS), several potential novel risk factors have emerged over the last two decades among which hyperhomocysteinemia (HHC) is one of them.  Methods: A hospital based prospective observational study was undertaken among the adult patients presented with stroke at Dr.Chandramma Dayananda Sagar Institute of Medical Education & Research, Harohalli, Ramanagara from April 2021 - March 2023. Patients with first episode of ischemic stroke in age group 15 years to 45 years of either sex were included. A predesigned, self-administered proforma was designed keeping the objectives of the study at the centre point. Carotid IMT was defined as the distance from the leading edge of the first echogenic line to the leading edge of the second echogenic line on the scans.  Results: Out of total 73 patients, about 78.1% of the study subjects were males and 21.9% were females with male:female ratio of 3.6:1. The maximum study population were between 40 – 45 Yrs (43.8%) with mean age 42.1 ± 2.0 years while total mean age of entire study population was 36.5 ± 6.5 years. 63.1% of the subjects had normal homocysteine with mean 12.5 ± 1.63 µmol/L while 36.9% of the subjects had hyperhomocysteinemia with mean 30.2 ± 11.6 µmol/L. 43.8% of the subjects had ≤0.8 mm of carotid intima-media thickness with mean 0.69 ± 0.07 mm while 56.2% had increased carotid intima-media thickness 1.09 ± 0.16 mm. Conclusion: Identification of newer individual risk factors have not only created a new challenge to the understanding of pathology of MI but have also opened up different approaches other than simply modifying the conventional risk factors in primary prevention of MI. Therefore, the role of newer risk factors has to be identified. In case of our study, serum homocysteine did not show any significant relation with age, sex, DM and diet pattern but goes significant with alcohol habit, hypertension and dyslipidemia.