Association between Serum Lipid Profiles and Early Neurological Deterioration in Acute Ischemic Stroke

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• 作者：Wi-Sun Ryu ; MD ; PhD^* ; ^{wisunryu@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Dawid Schellingerhout ; MD^&dagger ; ; Sang-Wook Jeong ; MD ; PhD^* ; Matthias Nahrendorf ; MD ; PhD^&Dagger ; ; Dong-Eog Kim ; MD ; PhD^* ; ^{kdongeog@duih.org" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Cerebral infarct ; lipids and lipoproteins ; apolipoproteins ; early neurological deterioration
• 刊名：Journal of Stroke and Cerebrovascular Diseases
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：25
• 期：8
• 页码：2024-2030
• 全文大小：485 K

文摘

Dyslipidemia is associated with chronic cardiovascular disease. However, the effect of dyslipidemia on acute ischemic stroke is unclear. We hypothesized that dyslipidemia could contribute to early neurological deterioration (END) after ischemic stroke.

Methods

A total of 410 acute ischemic stroke patients who were admitted to our stroke center within 24 hours after ictus were consecutively included in this study. END was defined as any new neurological symptoms/signs or any neurological worsening occurring during the admission and/or within 3 weeks after the index stroke. Multivariable logistic regression was used to examine the independent association between lipid indices and END.

Results

Mean age was 68.2 ± 13.3 years, 241 (58.8%) were male, and 78 (19.0%) experienced END. Almost END occurred within 3 days after admission (n = 70, 89.7%), and the majority of END was stroke progression (n = 68, 87.1%). In univariate analysis, high-density lipoprotein (HDL)-cholesterol levels (per 1 mmol/L; odds ratio [OR] .37; 95% CI .17-.80; P = .012) and apolipoprotein B (apoB)/apoA-I ratio (per 1 increase; OR 3.71; 95% CI 1.48-9.29; P = .005) were associated with END. In the multivariable analysis, adjusted ORs of END for the highest quartile of HDL-cholesterol and apoB/apoA-I ratio were .42 (95% CI .19-.94; P = .034) and 2.37 (95% CI 1.02-5.53; P = .045), respectively. The ratio of apoB/apoA-I was associated with END in large artery atherosclerosis stroke but not in other stroke subtypes.

Conclusions

Independent association of low HDL-cholesterol and high apoB/apoA-I ratio with END warrants further research to investigate if correction of the lipid profile during the acute period of ischemic stroke could reduce the risk of END.