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May 16, 2019

ESOC-2019

THE CONTRIBUTION OF CHOLESTEROL LEVELS TO THE SHORT- AND LONG-TERM PROGNOSIS OF ISCHEMIC STROKE

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cholesterol

ischemic stroke

outcome

Abstract

Abstract

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Keywords

cholesterol

ischemic stroke

outcome

Abstract

Background and Aims: We assessed the impact of total cholesterol levels (TChoL) on the prognosis of patients with a first-ever ischemic stroke (FEIS). Methods: Prospective population-based registry including all residents with a FEIS in 2011-2013 followed up to August 2018. Values of TChoL <200 mg/dL were considered normal, regardless of statin treatment at stroke onset. Results: Out of 919 patients with a FEIS, TChoL was available in 759 (82.6%), was normal in 511 (67.3%), and high in 248 (32.7%). Compared with those with high TChoL, patients with normal values were older, had more severe strokes and higher proportion of atrial fibrillation resulting in a higher proportion of cardioembolic strokes (P<0.05 for all comparisons). Besides, patients with normal TChoL had worse after stroke 30-day (P=0.001), 1-year (P=0.002), and 5-year CFRs (P=0.002) and survival probability at 30 days (P<0.001), 1 year (P<0.001), and 5 years (P<0.001) compared to those with high TChoL. The Cox analysis showed that age (HR 1.03, 95% CI 1.01-1.05), atrial fibrillation (HR 1.39, 95% CI 1.07-1.80), and diabetes mellitus (HR 1.43, 95% CI 1.08-1.89), but not normal TChoL were independent predictors of 5-year mortality. Notably, patients with normal TChoL had worse 30-day (20.4% vs 6.9%), 1-year (30.9% vs 13.7%), and 5-year (47.5% vs 28.4%) CFRs than those with normalized TChoL because of ongoing statin treatment (P<0.05 for all comparisons). Conclusions: Our results suggest that patients with normal TChoL have higher stroke severity and reduced survival after the FEIS, possibly depending on their older age and higher rate of cardiac embolism. The better prognosis of patients with high TChoL is not modified by the effective use of statins.

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© Copyright 2019 Morressier GmbH.
All rights reserved.