Comparison of serum lipid profile in ischaemic and haemorrhagic stroke

To compare serum lipid profile between patients of ischaemic and haemorrhagic strokes.

Cross sectional, comparative study.

Military Hospital, Rawalpindi, from August 2004 to February 2005.

Patients with diagnosis of stroke comprising 100 consecutive patients each of ischaemic and haemorrhagic strokes were included in the study while patients on lipid lowering therapy were excluded from study. To determine the subtype of stroke, clinical examination followed by CT scan of brain was done. A serum sample after 8 hours of overnight fasting was taken on the next day of admission for both groups of patients. Total serum cholesterol, triglycerides, LDLcholesterol, VLDL-cholesterol and HDL-cholesterol was determined, using enzymatic colorimetric method. Statistical analysis was done by comparison of lipid profile in two subgroups, using proportion test for any significant difference.

The mean age at presentation of patients with stroke was 64.2 + or - 12 years with a male to female ratio of 3.6:1. In 100 ischaemic stroke patients, raised serum total cholesterol was seen in 42, triglyceride in 04, LDL-cholesterol in 05 and VLDL-cholesterol in 07 patients. Serum HDL-cholesterol was below the normal reference in 31 cases. On the other hand, serum total cholesterol and triglycerides was raised in 05 patients each, LDL-cholesterol in 09 and VLDL-cholesterol in 03 patients of haemorrhagic stroke. Serum HDL-cholesterol was below normal in 04 patients of haemorrhagic stroke. On comparison, there were significantly greater number of patients with raised serum cholesterol and low HDL-cholesterol in ischaemic stroke than haemorrhagic stroke (p < 0.05). No statistical significance was found on comparing serum values of ischaemic and haemorrhagic stroke for triglycerides, LDL-cholesterol and VLDL-cholesterol.

Ischaemic stroke patients had high serum total cholesterol and lower HDL-cholesterol levels as compared to haemorrhagic stroke. High risk patients of stroke may be screened using serum lipid profile and further studies are suggested to evaluate the effect of lipid lowering therapy in terms of morbidity and mortality in ischaemic stroke patients.