Vitamin B-12, Homocysteine, and Hematological Parameters in Ischemic Stroke Patients

Background: A cerebrovascular accident or stroke is one of the leading causes of disability and death in the world. Several risk factors have been detected and extensively studied and are part of preventive strategies. Emerging risk factors for ischemic that have recently acquired interest are vitamin B-12 and homocysteine levels. A study has been conducted in a tertiary hospital in Chennai to evaluate the levels of vitamin B-12, homocysteine, and hematological variables. Aims: The objective of the study was to estimate the serum levels of homocysteine and vitamin B-12 in patients with ischemic stroke and transient ischemic attack and to analyze hematological parameters, including complete blood counts and peripheral smear and correlate with vitamin B-12. Materials and Methods: A total of 80 individuals with either ischemic stroke or transient ischemic attack were included in the study. Vitamin B-12, homocysteine, complete blood counts, and peripheral smear were analyzed for the patients. Results: Either frank or subclinical vitamin B-12 deficiencies were noted in 59 (73.8%) of the study population. Fifty-seven (71.2%) of the study population had elevated homocysteine. Fifty (62.5%) had a high neutrophil-to-lymphocyte (N:L) ratio and 52 (65%) had elevated red cell distribution width. Conclusion: High homocysteine levels are prevalent among ischemic stroke patients and this elucidates that homocysteine has a role in the thrombus formation and is a risk factor for the development of the stroke. It was also noted that vitamin B-12 deficiency, either frank or subclinical, is prevalent among these patients and can be a target for supplementation strategies.