Hyperhomocysteinemia Increases the Risk of Carotid Atherosclerotic Plaque in the High-Risk Group of Stroke: A Cross Sectional Study

Abstract

Abstract Hyperhomocysteinemia (Hhcy) is associated with ischemic stroke. Controlling or reversing the progression of atherosclerotic plaque is essential to prevent ischemic stroke. The purpose of this study was to explore the relationship between hyperhomocysteinemia and the risk of carotid atherosclerotic plaque in the high-risk population of stroke in China. We included the high-risk population of stroke over 40 years old in East China for analysis, measured the plasma total homocysteine level, and evaluated the carotid atherosclerotic plaque by ultrasound. After adjusting for demographic and vascular risk factors, multiple machine models were applied to analyze the correlation between hyperhomocysteinemia and carotid atherosclerotic plaque. The logistic model achieved the best performance at AUROC (0.720), followed by Bayes (0.708), and KNN (0.665). SVM with random forest did not work well. The results showed that 17006 (76.6%) of 22192 subjects had carotid atherosclerotic plaque. Among the population ≧ 55 years old, HHcy was significantly associated with carotid atherosclerotic plaque. HHcy (OR = 1.17, P < 0.001) is a risk factor of carotid atherosclerotic plaque. We conclude that hyperhomocysteinemia is an independent risk factor for carotid atherosclerotic plaque in stroke high-risk population.