Prognostic Value Of Serum Lipid Levels In Acute Ischemic Stroke

BackgroundThe incident and mortality of cardiovascular and cerebrovascular diseases are increasing in the world.Ischemic stroke is one of the common cerebrovascular diseases with high disability and fatality rates,which bring a heavy to social and family.Previous studies showed that dyslipidemia was associated with the incident and mortality of cardiovascular diseases.A serious of prospective and epidemiologic studies also showed that use of statins contributed to the benefits of secondary stroke prevention.However,the association of dyslipidemia and ischemic stroke remains uncertain.This review aimed to explore the prognostic value of lipids in acute ischemic stroke by enrolling a total of 871 patients with acute ischemic stroke.Objective1.To investigate the effect of serum lipid levels on short-term survival after acute ischemic stroke.2.To investigate the relationship between modified rankin scale and TC,TC/HDL-C.3.Assess the effect of TC and TC/HDL-C on prognosis,aim to guide patients treat after hospital discharge.MethodsPatients with acute ischemic stroke were collected from the First Affiliated Hospital of Nanjing Medical University and Jiangyin People' s Hospital in 2013 to 2015.A total of 871 patients were finally enrolled according to the inclusion and exclusion criteria.The baseline characteristics of patients were also collected including 3-month mRS,risk factors and serum lipid profile.The primary endpoint was death.Secondary endpoint was good(modified Rankin Scale score 0-2 or equal to prestrike modified Rankin Scale score)at 3 months.The logistic regression analysis was conducted to evaluate predictors of 3-month outcomes.ResultsOf 871 patients enrolled in the final analysis,94(10.8%)individuals died during 3 months of observation.The serum TC and TC/HDL-C levels at admission were significantly associated with stroke outcomes at 3 months,and the HDL-C level was only correlated with the good outcomes at 3 months.Mortality risk was markedly decreased for patients with high TC/HDL-C ratio(odds ratio:0.23,95%confidence interval[CI]:0.10-0.50 for Q4:Q1;P-trend=0.041)after adjustment.The effect of TC/HDL-C ratio on the probability of good outcomes was still obvious(odds ratio:2.18,95%CI:1.40-3.39 for Q4:Q1;P-trend=0.029).Patients with low TC increased the risk of death(odds ratio:0.38;95%[CI]:0.20-0.76 for Q4:Q1;P-trend= 0.046),high probability of TC patients with good outcomes increased(odds ratio:2.39;95%CI:1.55-3.69 for Q1:Q4;P-trend<0.001).ConclusionHigh TC/HDL-C ratio and TC may be associated with increased short-term survival and better outcomes after acute ischemic stroke.