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Year : 2009  |  Volume : 57  |  Issue : 5  |  Page : 631-635

Methylenetetrahydrofolate reductase C677T polymorphism in Iraqi patients with ischemic stroke

1 Department of Pathology, College of Medicine, University of Dohuk, Iraq
2 Department of Pathology, Azadi Teaching Hospital, University of Dohuk, Iraq
3 Scientific Research Center, University of Dohuk, Iraq

Date of Acceptance02-Jul-2009
Date of Web Publication20-Nov-2009

Correspondence Address:
Nasir A.S Al-Allawi
Head of Department of Pathology, College of Medicine, University of Dohuk
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0028-3886.57821

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 ╗ Abstract 

Background: Data are conflicting concerning the association between ischemic stroke and methylenetetrahydrofolate reductase (MTHFR) C677T mutation. Studies addressing this matter in developing countries are limited. Aim: This study was undertaken to evaluate MTHFR C677T gene polymorphism as a possible risk factor in patients with ischemic stroke in Iraq. Settings and Design: A case-control study in a major teaching hospital in Northern Iraq. Materials and Methods: Study population included 70 patients with ischemic stroke diagnosed by computed tomography (CT) or magnetic resonance imaging (MRI) and 50 controls matched by age and sex. All the patients and controls had detailed neurologic examination and blood sugar, lipid profile, total homocysteine, as well as, MTHFR gene analysis. The MTHFR C677T mutation status was detected in the amplified products using reverse hybridization to specific mutant and wild oligonucleotide probes by a colorimetric microwell plate method. Statistical Analysis: Mann-Whitney U test and Chi-square tests were used to find the significance. Results: The median age of the patients was 60 years and 54% were males. The MTHFR C677T gene analysis detected TT genotype in 20% of patients and in 6% of controls and CC genotype in 37% of the patients and in 54% of the controls. The calculated risk of ischemic stroke in the subjects with TT genotype was 4.85 times more than the subjects with CC genotype (P=0.03). Serum homocysteine level was significantly higher in the patients than the controls (P=0.02). The serum homocysteine levels were significantly higher in those with TT and CT genotypes when compared to those with CC genotype (P < 0.001 and P=0.04, respectively). Conclusion: In the Iraq population studied MTHFR C677T TT genotype was a significant risk factor for ischemic stroke and it was related to the increased total homocysteine levels and the risk for ischemic stroke was graded with increasing MTHFR 677T allele dose.

Keywords: Homocysteine, ischemic stroke, methylenetetrahydrofolate reductase C677 T

How to cite this article:
Al-Allawi NA, Avo AS, Jubrael JM. Methylenetetrahydrofolate reductase C677T polymorphism in Iraqi patients with ischemic stroke. Neurol India 2009;57:631-5

How to cite this URL:
Al-Allawi NA, Avo AS, Jubrael JM. Methylenetetrahydrofolate reductase C677T polymorphism in Iraqi patients with ischemic stroke. Neurol India [serial online] 2009 [cited 2022 Nov 30];57:631-5. Available from: https://www.neurologyindia.com/text.asp?2009/57/5/631/57821

 ╗ Introduction Top

Ischemic stroke is a major cause of morbidity and mortality in developed countries, and World Health Organization (WHO) anticipates similar trends in developing countries within the next decade. [1] Stroke prevention should be one of the immediate priorities of health authorities in developing countries. Several modifiable risk factors have been identified and would be suitable targets for intervention; one of them is total homocyteine concentration, though the data is controversial. [2] Hyperhomocyteinemia may be acquired or inherited and the frequent inherited cause is the methylenetetrahydrofolate reducatase (MTHFR) C677T mutation. This mutation is responsible for Ala223Val substitution in a highly conserved residue of the molecule, rendering the enzyme thermolabile and leading to hyperhomocysteinemia, particularly in homozygous individuals. [3] The worldwide prevalence of MTHFR C677T mutation in its homozygous state is variable and ranges between 8% and 18% in Europe and Northern America. The mutation is uncommon in Africans and people of African origin. [4] Studies from Asian countries reported variable frequencies: 11% in Japanese and Chinese and 0-1.2% in Indians. [4],[5],[6],[7] The reported frequency in the studies from Eastern Mediterranean region range between 5.1% and 18%. [8],[9],[10] A recent study from Iraq revealed a frequency of 8% among healthy blood donors. [11] There are no studies addressing the relation between MTHFR C677T mutation and ischemic stroke from Iraq.

 ╗ Materials and Methods Top

Of the 83 consecutive patients with ischemic stroke attending Azadi Teaching Hospital, Dohuk, Iraq, between December 2005 and April 2007, 70 patients were recruited for this study. The inclusion criteria was ischemic stroke confirmed by magnetic resonance imaging (MRI) and/or computer tomography (CT). Patients with renal disease, cardioembolic stroke, malignancy, and pregnant women were excluded. During the same period, 50 age and sex matched healthy subjects attending the outpatient laboratory of the hospital for routine general checkup with no history of venous or arterial thrombosis were recruited as controls. The study was approved by the ethical committee at the College of Medicine, and informed consent was obtained from all enrollees.

All the patients had a detailed history and neurologic examination, Based on neuroimaging findings, patients were categorized into lacunar or nonlacunar stroke according to criteria by Ohira et al. [12] All patients and controls had fasting blood sugar and lipid profile (Biomereaux, France). Serum total homocystiene was Estimated using enzymatic assay (Diazyme laboratories, Germany), [13] with an automatic analyzer (TARGA 3000, Biotanica instruments, Italy). Blood collected in the EDTA vial was frozen within one to two hours at -208, and kept for DNA extraction, DNA was extracted within three months of sample collection using a phenolchloroform method and was amplified using a Primus 25 thermocycler (MWG-Germany) with specific primers (ViennaLab, Austria) and a cycling program consisting of pre-polymerase chain reaction (PCR) at 94░C for 2 minutes, followed by 30 cycles at 94░C for 15 sec; 58░C for 30 sec; 72░C for 30 sec, and a final extension of 3 minutes at 72░C. The MTHFR C677T mutation status was detected in the amplified products using reverse hybridization to specific mutant and wild oligonucleotide probes by a colorimetric microwell plate method, [14] according to the manufacturer's instructions (ViennaLab, Austria).

Statistical analysis was done using SPSS software package. Mann-Whitney U tests and Chi square tests were used whenever appropriate and a P < 0.05 was considered significant.

 ╗ Results Top

The median age of the patients with ischemic stroke was 60 years (male : female: 1.19:1) and for the controls 62 years (male : female: 1.08:1). Of the 70 patients with ischemic stroke, 12 patients had lacunar infarct and the remaining 58 had nonlacunar infarct. [Table 1] shows the distribution of MTHFR C677T genotypes [TT Homozygous; CT Heterozygous; and CC wild type] in patients and controls with relevant clinical and biochemical data. TT genotype was detected in 20% of patients and 6% of controls, while CC genotype was detected in 37% of patients and 54% of controls. The calculated risk of ischemic stroke in the subjects with TT genotype was 4.85 fold (95% CI: 1.14-28.73) higher than the subjects with CC genotype, ( P = 0.03).

The median serum homocysteine levels in patients with ischemic stroke was 14.2 μmol/L (mean, 20.9 + 22.2) where as the median levels in controls was 9.7 μmol/L (mean 12.3 + 10.2) ( P = 0.02). Highest homocysteine levels were found in those with TT genotype and the homocysteine levels were significantly higher than in those with the CC genotype, but not in those with the CT genotype ( P < 0.001 and 0.06, respectively). Furthermore, homocysteine levels were also significantly higher in CT compared to CC genotype ( P = 0.04) [Table 2].

No significant differences were found in age, sex, MTHFR C677T mutation status, total homocysteine levels or other biochemical studies between patients with lacunar stroke and nonlacunar stroke. However, history of hypertension and smoking were significantly higher among patients with lacunar infarct ( P = 0.001 and 0.02, respectively).

 ╗ Discussion Top

The study suggests that in Iraq population the risk of ischemic stroke Is about five fold higher in subjects homozygous for MTHFR C677T (TT genotype) gene mutation when compared to those homozygous for the wild gene (CC genotype). Recent meta-analysis including 13,928 subjects, showed similar high significant overall pooled odds ratio for stroke in subjects with the TT genotyped when compared to the CC genotype, 1.26 (95% confident intervals (CI), 0.56 to 17.92). [15] Another meta-analysis, including 14,870 subjects showed a graded increase in ischemic stroke risk with increasing MTHFR 677T allele dose. [16] Some of the case-control studies from China and Japan showed similar significant increased risk of ischemic stroke in TT genotype. [17],[18] While studies from India did not find such significant association though TT genotype was more frequent in the patients with ischemic stroke. This is probably related to the low prevalence of TT genotype in the general population. [6],[7],[19],[20],[21] One hospital based study from India reported the probability of carrying the mutant allele (TT or CT genotypes) at 22.29 fold higher in patients than controls. [22] In our study total serum homocysteine was significantly higher in subjects with TT and CT genotypes. Similar were the findings in the meta-analysis including 16849 subjects. [23] Case control studies from Asia, also confirm our observations. [6],[17],[18] Casas and Coworkers [15] demonstrated that the actual increase in the risk of stroke in homozygous (TT) individuals was close to that predicted from the difference in homocysteine level conferred by this variant. This concordance is consistent with a casual relation between homocysteine and ischemic stroke. [15]

Such a correlation between serum total homocysteine levels and C677T MTHFR mutation is quite expected, since MTHFR catalyzes the reduction of 5,10 MTHF to 5 MTHF, the predominant circulatory form of folate and carbon donor for the remethylation of homocysteine to methionine and MTHFR C677T leads to a reduced MTHFR activity and thus elevated homocysteine. [24] In this case-control study significantly higher serum total homocysteine levels were observed in patients with ischemic stroke. Similar were the observations in other case control studies and also in some of the prospective studies. [17],[20],[25],[26],[27],[28],[29] This association with elevated homocysteine levels was stronger in case control studies than the association observed in the prospective studies, This discrepancy may partly be explained as elevated homocysteine levels may be a reflection of an acute phase reaction. [30] In the present study homozygous MTHFR mutation (TT) was associated with higher serum total homocysteine levels and also with the high risk for ischemic stroke. This would probably indicates that high levels of serum total homocysteine is a risk factor for ischemic stroke. These observations are supported by the meta-analyses using mendelian randomization, to assess the consistency between risk estimates obtained from genotype-disease studies and phenotype-disease studies, relating to the MTHFR mutation, homocysteine and the risk of ischemic stroke, which showed a causal relationship between homocysteine and ischemic stroke. [15]

The precise mechanisms underlying the apparent adverse effect of hyperhomocysteinemia on the risk of the ischemic stroke are not clear, although several mechanisms have been proposed. Hyperhomocysteinemia may cause a rise in arterial blood pressure and thus increase the risk of ischemic stroke. [28] Another possible mechanism is that elevated total serum homocysteine induces oxidative injury to vascular endothelial cells and impairs the production of nitric oxide, a strong vasodilator, from the endothelium. [31] Hyperhomocyteinemia has been shown to enhance platelet adhesion to endothelial cells [32] and also to promote growth of vascular smooth muscle cells. [33] Hyperhomocysteinemia is associated with higher levels of prothrombotic factors such as b- thromboglobulin, tissue plasminogen activator, and factor VIII: C. [34]

Confirming a causal relationship between elevated homocysteine and stroke is of clinical importance as serum homocysteine could be lowered by the B vitamin supplementation (folic acid, B12 and B6). [35] But the real challenge is to show that lowering homocysteine lowers the risk of stroke or death. Several trials have been done to address this issue. [36],[37],[38],[39] and some more studies are under way the results of which are awaited. [40],[41] One of the major limitations of our study was that we had not done a detailed nutritional status evaluation of both the patients and controls. We had also not done the folate, B12 and B6 status. These limitation emphasize the need for future studies to determine the folate, B12 and B6 status, in conjunction with serum total homocyteine and MTHFR C677T genotypes, in healthy subjects and patients with ischemic stroke in Iraq. Such data is important to plan national programs for possible preventive intervention.

 ╗ Acknowledgment Top

Authors acknowledge with gratitude the critical review of the manuscript by Professor Michael Hughson (Emeritus Professor of Pathology, University of Mississippi Medical Center, US).

 ╗ References Top

1.Murry CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990-2020: Global burden of disease study. Lancet 1997;349:1498-504.   Back to cited text no. 1      
2.Goldstein LB, Adams R, Albert MJ, Appel LJ, Brass LM, Bushnell CD, et al. Primary prevention of ischemic stroke. Stroke 2006;37:1583-633.  Back to cited text no. 2      
3.Gemmati D, Serino ML, Trivellato C, Fiorini S, Scapoli GL. C677T substitution in the methylenetetrahydrofolate reductase gene as a risk factor for venous thrombosis and arterial disease in selected patients. Haematologica 1999;84:824-8.  Back to cited text no. 3      
4.Botto L, Yang Q. 5,10-Methyelenetetrahydrofolate reductase gene variants and congenital Anomalies: A HuGE review. Am J Epidemiol 2000;151:862-77.   Back to cited text no. 4      
5.Ho CH. Prevalence of Prothrombin 20210A and Methylenetetrahydrofolate reductase C677T genetic mutation in the Chinese population. Ann Haematol 2000;79:239-42.  Back to cited text no. 5      
6.Radha Rama Devi A, Govindaiah V, Ramakrishna G, Naushad SM. Prevalence of methylene tetrahydrofolate reductase polymorphism in South Indian population. Current Science 2004;86:440-3.   Back to cited text no. 6      
7.Refsum H, Yajnik CS, Gadkari M, Schneede J, Vollset SE, Örning L, et al. Hyperhomocysteinemia and elevated methylmalonic acid indicate a high prevalence of cobalamin deficiency in Asian Indians. Am J Clin Nutr 2001;74:233-41.  Back to cited text no. 7      
8.Hermann W, Obeid R, Jouma M. Hyperhomocysteinemia and vitamin B12 deficiency are more striking in Syrians than Germans - causes and implications. Atherosclerosis 2003;166:143-50.  Back to cited text no. 8      
9.Golbahar J, Fathi Z, Tamadon M. Distribution of 5,10 Methylenetetrahydrofolate reductase (C677T) and its association with red blood cell 5-methyltetrahydrofolate in healthy Iranians. Clin Nutr 2005;24:83-7.  Back to cited text no. 9      
10.Eid SS, Rihani GR. Prevalence of factor V Leiden, Prothrombin G20210A and MTHFR C677T mutations in 200 Jordanian Healthy individuals. Clin Lab Sci 2004;17:200-2.  Back to cited text no. 10      
11.Al-Allawi N, Jubrael J. Thrombophilic mutations in the Dohuk region of Iraq. Proceedings of the 2 nd international Jordanian society of pathology conference. Amman, Jordan: 2006.  Back to cited text no. 11      
12.Ohira T, Shahar E, Chambless LE, Rosamond WD, Mosley TH, Folsom AR. Risk factors for ischemic stroke subtypes: The atherosclerosis risk in communities study. Stroke 2006;37:2493-8.  Back to cited text no. 12      
13.Dou C, Xia D, Zhang L, Chen X, Flores P, Datta A, Yuan C. Development of a novel enzymatic cycling assay for total homocysteine. Clin Chem 2005;51:1987-9.  Back to cited text no. 13      
14.Hézard N, Cornillet P, Vallade A, Nguyen P. Detection of factor V Leiden using ASO (allele specific oligonucleotide). Thromb Haemost 1997;78:1296.  Back to cited text no. 14      
15.Casas JP, Bautista LE, Smeeth L, Sharma P, Hingorani AD. Homocysteine and stroke: Evidence on a causal link from mendelian randomization. Lancet 2005;365:224-32.  Back to cited text no. 15      
16.Cronin S, Furie KL, Kelly PJ. Dose-related Association of MTHFR 677T allele with risk of Ischemic stroke: Evidence from a cumulative meta-analysis. Stroke 2005;36:1581-7.  Back to cited text no. 16      
17.Li Z, Sun L, Zhang H, Liao Y, Wang D, Zhao B, et al. Elevated plasma homocysteine was associated with hemorrhagic and ischemic stroke, but Methylenetetrahydrofolate reductase gene C677T polymorphism was a risk factor for thrombotic stroke. Stroke 2003;34:2085-90.  Back to cited text no. 17      
18.Morita H, Kurihara H, Tsubaki S, Sugiyama T, Hamada C, Kurihara Y, et al. Methylenetetrahydrofolate reductase gene polymorphism and ischemic stroke in Japanese. Arteriovasculer Thromb Vasc Biol 1998;18:1465-9.   Back to cited text no. 18      
19.Mukherjee M, Joshi S, Bagadi S, Dalvi M, Rao A, Shetty KR. A low prevalence of the C677T mutation in the methylenetetrahydrofolate reductase gene in Asian Indians. Clin Genet 2002;61:155-9.   Back to cited text no. 19      
20.Panigrahi I, Chatterjee T, Biswas A, Behari M, Ved Choudhry P, Saxena R. Role of MTHFR C677T polymorphism in ischemic stroke. Neurol India 2006;54:48-52.  Back to cited text no. 20  [PUBMED]  Medknow Journal  
21.Kalita J, Srivastava R, Bansal V, Agarwal S, Misra UK. Methylenetetrahydrofolate reductase gene polymorphism in Indian stroke patients. Neurol India 2006;54:260-3.   Back to cited text no. 21  [PUBMED]  Medknow Journal  
22.Alluri RV, Mohan V, Komandur S, Chawda K, Chaudhuri JR, Hasan Q. MTHFR C677T gene mutation as a risk for arterial stroke: A hospital based study. Eur J Neurol 2005;12:40-4.  Back to cited text no. 22      
23.Wald DS, Law M, Morris JK. Homocysteine and Cardiovascular Disease: Evidence on causality from meta-analysis. BMJ 2002;325:1202-6.  Back to cited text no. 23      
24.Frosst P, Blom HJ, Milos R, Goyette P, Sheppard CA, Mathews RG, et al. A candidate genetic risk factor for vascular disease: A common mutation in Methylenetetrahydrofolate reductase. Nat Genet 1995;10:111-3.  Back to cited text no. 24      
25.Yoo JH, Chung CS, Kang SS. Relation of plasma homocysteine to cerebral infarction and cerebral atherosclerosis. Stroke 1998;29:2478.  Back to cited text no. 25      
26.Perry IJ, Refsum H, Morris RW, Ebrahim SB, Ueland PM, Shaper AG, et al. Prospective study of serum total homcysteine concentration and risk of stoke in middle aged British men. Lancet 1995;346:1395-8.  Back to cited text no. 26      
27.Bostom AG, Rosenberg IH, Silbershatz H,Jacques PF, Selhub J, D'Agostino RB, et al. Non fasting plasma total homocysteine levels and stroke incidence in elderly persons: The Framingham Study. Ann Intern Med 1999;131:352-5.  Back to cited text no. 27      
28.Iso H, Moriyamam Y, Sato S, Kitamura A, Tanigawa T, Yamagishi K, et al. Serum total homocysteine concentration and risk of stroke and its subtypes in Japanese. Circulation 2004;8:2766-72.  Back to cited text no. 28      
29.Modi M, Prabhakar S, Majumdar S, Khullar M, Das CP. Hyperhomocysteinemia as a risk factor for ischemic stroke: An India scenario. Neurol India 2005;53:297-301.   Back to cited text no. 29  [PUBMED]  Medknow Journal  
30.Dudman NP. An alternative view of homocysteine. Lancet 1999;354:2072-4.  Back to cited text no. 30      
31.Stamler JS, Osborne JA, Jaraki O, Rabbani LE, Mullins M, Singel D, et al. Adverse vascular effects of homocysteine are modulated of nitrogen endothelium derived relaxing factor and related oxides of nitrogen. J Clin Invest 1993;9:308-18.  Back to cited text no. 31      
32.Daradik R, Varon D, Tamarin I, Zivelin A, Salomon O, Shenkman B, et al. Homocysteine and oxidized low density lipoprotein enhanced platelet adhesion to endothelial cells underflow conditions: Distinct mechanisms of thrombogenic modulation. Thromb Haemost 2000;83:338-44.  Back to cited text no. 32      
33.Tsai JC, Perrella MA, Yoshizumi M, Hsieh CM, Haber E, Schlegel R, et al. Promotion of vascular smooth muscle growth by homocysteine: A link of atherosclerosis. Proc Natl Acad Sci USA 1994;91:6369-73.  Back to cited text no. 33      
34.Schreiner PJ, Wu KK, Malinow MR, Stinson VL, Szklo M, Nieto FJ, et al. Hyperhomocyst(e)inemia and homeostatic factors: The atherosclerosis risk in communities study. Ann Epidemiol 2002;12:228-36.  Back to cited text no. 34      
35.Wald DS, Bishop L, Wald NJ. Randomized trial of folic acid supplementation on serum homocysteine level. Arch Intern Med 2001;161:695-700.   Back to cited text no. 35      
36.Mark SD, Wang W, Fraumeni F Jr, Li JY, Taylor PR, Wang GQ, et al. Lowered risk of hypertension and cerebrovascular disease after vitamin/mineral supplementation: The Linxian nutrition intervention trial. Am J Epidemiol 1996;143:658-64.  Back to cited text no. 36      
37.Toole JF, Malinow MR, Chambless LE, Spence JD, Pettigrew LC, Howard VJ, et al. Lowering homocysteine in patients with ischemic stroke to prevent recurrent stroke, myocardial infarction and death: The vitamin intervention for stroke prevention (VISP) randomized controlled trial. JAMA 2004;291:565-75.  Back to cited text no. 37      
38.Lonn E, Yusuf S, Arnold MJ, Sheridan P, Pogue J, Micks M, et al. Homocysteine lowering with folic acid and B vitamins in vascular disease. N Eng J Med 2006;354:1567-77.  Back to cited text no. 38      
39.Yang Q, Botto LD, Erickson JD, Berry RJ, Sambell C, Johansen H, et al. Improvement in stroke mortality in Canada and united states: 1990 to 2002. Circulation 2006;113:1335-43.  Back to cited text no. 39      
40.Murthy JM. Hyperhomocysteinemia, ischemic stroke, and B-vitamin treatment: The jury is still out. Neurol India 2005;53:271-2.  Back to cited text no. 40  [PUBMED]  Medknow Journal  
41.Ueland PM, Clarke R. Homocysteine and cardiovascular risk: Considering the evidence in the context of study design, folate fortification, and statistical power. Clin Chem 2007;53:807-9.   Back to cited text no. 41      


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20 The Genotype and Allele Distributions of MTHFR C677T and A1298C Gene Polymorphisms in Patients with Cerebrovascular Disease, Coagulation Disorder and those Pre-Diagnosed with Hypertension in Van Province and its Environments
Ahmet D÷nder, Ragip Balahoroglu, Erdem ăokluk, Haluk DŘlger, M. Ramazan Sekeroglu, Tahsin Karakoyun
European Journal of Basic Medical Sciences. 2012; 2(2): 41
[Pubmed] | [DOI]
21 Evaluation of MTHFR C677T polymorphism in ischemic and hemorrhagic stroke patients. A caseľcontrol study in a Northern Indian population
B.I. Somarajan,J. Kalita,B. Mittal,U.K. Misra
Journal of the Neurological Sciences. 2011; 304(1-2): 67
[Pubmed] | [DOI]
22 C677T and A1298C methylenetetrahydropholate reductase (MTHFR) polymorphisms as factors involved in ischemic stroke
Arsene, D. and GăÄinăÄ, G. and BăÄlescu, C. and Ardeleanu, C.
Romanian Journal of Morphology and Embryology. 2011; 52(4): 1203-1207
23 TT genotype of the methylenetetrahydrofolate reductase C677T polymorphism is an important determinant for homocysteine levels in multi-ethnic malaysian ischaemic stroke patients
Mejia Mohamed, E.H., Tan, K.S., Ali, J.M., Mohamed, Z.
Annals of the Academy of Medicine Singapore. 2011; 40(4): 186-191
24 Meta-analysis of 5, 10-methylenetetrahydrofolate reductase gene polymorphism as a risk factor for ischemic cerebrovascular disease in a Chinese Han population
Bai, H.
Neural Regeneration Research. 2011; 6(5): 360-365
25 Evaluation of MTHFR C677T polymorphism in ischemic and hemorrhagic stroke patients. A case-control study in a Northern Indian population
Somarajan, B.I., Kalita, J., Mittal, B., Misra, U.K.
Journal of the Neurological Sciences. 2011; 304((1-2)): 67-70
26 Prognostic faktors of stroke: The review of factors related to patients [─░nmeye ai╠çt prognosti╠çk fakt├Ârler: Hastaya ai╠çt fakt├Ârleri╠çn g├Âzden ge├ži╠çri╠çlmesi╠ç]
Duman, T. and Dede, H.├ľ.
Turk Serebrovaskuler Hastaliklar Dergisi. 2010; 16(1): 7-16
27 Editorial: Geographical variations of prothrombotic polymorphisms: An important emerging risk factor for ischemic stroke
Thomas, M., Pandian, J.D.
Neurology India. 2009; 57(5): 523-524


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Online since 20th March '04
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