Background and Aims:
A 25% of strokes have an atherothrombotic etiology, being dislipemia one of the main associated factors (30%). We do not know the correct control of dyslipidemia in patients with atherothrombotic stroke admitted in our stroke unit and follow-up.

Methods:
A total of 1012 patients with ischemic stroke were admitted in out stroke unit between January 2014 to July 2017, we analyzed 201 patients with atherothrombotic etiology. We assessed the incidence of dyslipidemia in the laboratory test during admission and hospitalization, after discharge during control in general practicioner, the type and dose of lipid-lowering treatment

Results:
At the time of admission, 21% patients had total cholesterol levels>200 mg/dl and 36% had an LDL-cholesterol>100 mg /dl (18% had already on lipid-lowering therapy). Up to 79% had an LDLc>1.8 mmol/l and 39% had hypertriglyceridemia (>1.7 mmol/l).  We found 84% of patients followed analytical controls in their primary medical center between 4 to 6 months after stroke unit discharge. Only 8.7% had a total cholesterol>200mg/dl but 22% had LDLc>2.6mmol/l and up to 57% probably with LDLc>1.8mmol/l  in spite of treatment with statins.(half of patients have already been treated with very high-intensity statins).  About 18% persisted with suboptimal triglyceride levels.

Conclusions:
There is a subgroup of patients with a very high vascular risk that remains at LDL-cholesterol levels over recommended levels of secondary prevention after stroke (22-57% according to the latest objective of LDL-cholesterol and latest recommendations). Almost half  of them presents a suboptimal control that  might justify the treatment with antiPCSK9, as the main therapeutic alternative.

IS THERE A PLACE FOR MONOCLONAL ANTIBODIES (ANTI PCSK9) IN THE STROKE UNITS?