Optimization of prevention of recurrent ischemic stroke by taking into account genetic risk factors

Abstract

We have examined 150 patients who had an ischemic stroke (86 men, 64 women) 45-84 years of age. All patients were genetically tested in the form of venous blood collection and detection of the mutation pattern of the gene MTHFR C677T (CC, CT or TT variants). The patients were divided into groups according to detected MTHFR C677T gene mutations and prophylactic treatment. Patients with a MTHFR C677T type mutation were included in the CC1 group, which in addition to the main prophylactic treatment have received drugs with folic acid (vitamin B9) in a dose of 1 mg (optimized prophylaxis). The CC2 group had the same mutation, but received only the main prophylactic treatment (enalapril 20 mg, aspirin 100 mg and rosuvastatin 20 mg). Similarly, the groups ST1 (n = 21), CT2 (n = 21), TT1 (n = 9) and TT2 (n = 9) were distributed. The risk of stroke among patients with CC and CT mutations did not significantly differ in the case of optimized pharmacological prevention. However, in the case of TT mutation, the data has shown a high probability of recurrent stroke due to genetically determined hyperhomocysteinemia and a significant difference in the frequency of repeated cerebral events on the background of treatment with folic acid. Thus, an optimized method of pharmacological prevention of acute ischemic stroke allows to effectively carry out prevention of recurrent ischemic stroke, depending on the genetic features of the patient.