1137 Prevalence of methylenetetrahydrofolate reductase gene C677T polymorphism and its association with cerebral venous thrombosis in South Indians

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Poster Abstracts

Thursday, November 10, 2005

McGuire, A 1, Raiko, M ~, Christensen, NIz, Whittle, 13. 1LSE Health &

Social Care, London School of Economies, United Kingdom; 2Nova Nordisk A/S, Bagsvaerd, Denmark; 3Department of Clinical Neurosciences, Universi(v of Edinburgh, UnitedKingdom Backgrouml: Intracerebral hemorrhage (ICH) represents the most

severe form of stroke, yet little is known about long-term prognosis and requirements for health care. We report long-term survival, morbidity and health care needs over a 9-year period following a firstever ICH. Methods: Retrospective inception cohort design based on data from a National Health Service (NHS) Medical-Record Linkage Database. All patients in Scotland with a first diagnosis of ICH in 1993 were evaluated. Results: ICH was diagnosed in 735 patients. Mean age was 65 with 90% of the population between 40 and 99 years of age, and less than 1% under age 20. Acute in-hospital mortality was 46.66 %, 51.2',/0 were dead by the end of the first year and 71.3% nine years later. Total recurrence of ICH was 12% and 26% per year experienced cardiovascular complications requiring hospital care. @proximately 50% of the survivors were readrnitted each year and 50% of readrnissions involved surgical interventions. Mean cost of initial hospital care was £3,510 (LOS 36 days) while the cost of follow-up hospital care varied between £800 and £1,500 per readmission. Total cost of hospital care averaged £6,044 per patient (i£5,709 at 5% discount rate) implying a total cost to the NHS of£4,442,340 over the 9-year period (i£4,196,115 if discounted at 5%). Conclusion: Following an initial ICH, individuals have a very poor prognosis over the short-term and require siguificant follow-up care throughout their remaining life. High readnffssion rates, particularly for cardiovascular complications, are associated with prolonged hospital stays and significant operative rate.

Christopher R ~, Nagaraja D 1, Kruthika V ~, Bharatkumar PV 1, Vinod P~. ZNationalInstitute of Mental Health and Neuro Sciences,

Bangalore, India Background: A C

> T substitution at nucleotide 677 of 5,10methylenetetrahydrofolate reductase (MTHFR) gene which reduces the activity of M T H F R , one of the key enzymes that catalyzes the remethylation o f homocysteine, has been reported to be associated with venous thrombosis. The relationship between this thrombophilic polymorptffsm and cerebral venous thrombosis (CVT) remains unclear. In tiffs study, we exanffned the association between M T H F R C677T gene polymorptffsm and CVT in a South Indian population. Methods: A case-control cohort, consisting of 113 CVT patients (186 puerperal and 27 non-puerperal, age range 18-50 years) and 113 age- and gender-matched clinically normal controls, were used for the study. The diagnosis of CVT of all study patients was confirmed by cranial MRI. The M T H F R genotype was analyzed by polymerase drain reaction followed by Hinff digestion. Results: The M T H F R C677T mutation was observed in 19 patients (114 heterozygotes and 5 homozygotes) and 20 controls (116 heterozygotes and 4 homozygotes). Comparison of C677T allele frequencies revealed a similar proportion of the mutant 677T allele in the CVT patients (17%) as well as in controls (18%) (p -- 1.000). Similarly, in the patient group there was no siguificant difference in the 677T allele frequencies between those with puerperal CVT (16.3%) compared to non-puerperal CVT (18.5%) (lJ -- 0.773). The odds ratio for CVT associated with the carriership of the mutant M T H F R allele was 0.94 (95% CI -- 0.45 1.98, p -- 1.000). Conclusion: These findings suggest that M T H F R C677T polymorptffsm does not play a significant role in the pathogenesis of CVT in patients from South India. 1138

1136 Incidence and risk factors of fatigue after stroke: a follow-up study Christensen D, RN ~, Harder I, RN, PhD 2, Johnsen SP, MD, PhD 3, Andersen G, MD, DMSc 1, KJrkevold M, RN, EdD 2. 1Department of

Neurology, Aarhus UniversityHospital, Aarhus, Denmark; 2 Department of Nursing Science, Aarhus University, Aarhus, Denmark; 3 Department of Clinical EpidemiMogy, Aarhus University Hospital, Aarhus, Denma~]c Background: Fatigue after stroke is a common complaint, with

reported incidences ranging from 30 68%. However, few studies have provided detailed data on incidence and risk factors. Objective: To exanffne the incidence and risk factors of fatigue after stroke among first-ever stroke patients. Methods: We conducted a prospective follow-up study among 192 stroke patients admitted to acute stroke units at Aarhus University Hospital during March 1, 2003 February 28, 2005. Data were collected upon adnffssion and after three months. Fatigue was assessed using the Multidimensional Fatigue Inventory-20 and was defined as a General Fatigue score of _>12. Possible risk factors included age, sex, marital status, Scandinavian Stroke Scale score and Modified Rankin Score. Data were analysed using logistic regression. Results: Seventy patients (45"/0) had developed fatigue after three months of follow-up. Male sex (adjusted Relative Risk (RR) -- 0.65, 95% Confidence intervals (CD: 0.3~1.33) and not living alone (adjusted R R -- 0.57, 95% CI: 0.28-1.20) appeared to be associated with a decreased risk of fatique, although these associations did not reach statistical significance. Conclusion: Fatique was frequently observed among patients with stroke and may be associated with sex and marital status.

Use of nonpharmacologieal measures in the treatment and prevention of Stroke and Heart Attack Cop Blazic, N l, Roje Bedekovic, M ~, Planinc, D 1, Demarin, V ~.

1Sestre Milosrdnice University Hospital, Department Of Neurology', Zagreb, Croatia Stroke and heart attack rank high on the morbidity and mortality scale both in Croatia and worldwide. As these are diseases from which a part of patients die, a part have lower or higher degree of disability and only a minor part recover completely, the problem of treatment and prevention of these diseases is in the very focus of interest of a large nmnber of researchers. New potential risk factors for cerebrovascular and cardiovascular diseases are discovered on an almost daily basis. It seems that more effort has been invested in the detection of risk factors than in the use of efficient measures for their removal or control. It is by no means infrequently that individuals with a history of stroke or heart attack after the early phase of recovery, resmne of smoking habit, fail to follow the principles of healthy nutrition, neglect light physical activity, unnecessarily get exposed to stressful situations or those than cannot be avoided tend to solve in an inappropriate manner, and eventually sustain reccurent stroke or heart attack in spite of regular use of pharmacological agents. Therefore, during patient hospitalization and posthospital follow-up, in addition to the usual control neurologic and cardiologic examinations, patients should be provided appropriate assistance in the process of lifestyle modification, in cooperation with their family members, in order to reduce the possibility o f the disease recurrence. The professionally justifiable, available and cost-effective non-pharmacological measures that are relevant for both prevention and efficient therapy of Cerebrovascular and cardiovascular diseases are discussed.

1137 Prevalence of MetlxylenetetrabytIrofolate Reductase Gene C677T Polymorptfism and its association with Cerebral Venous Thrombosis in South Indians

1139 Incidence of a First-Ever Acute Ischaeufic Cerebrovascular Event in Rural and Urban Northern Portugal: a commutfity-based study