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High cholesterol levels are associated with improved long-term survival after acute ischemic stroke

Ioanna Markaki1, Ulrik Nilsson1, Konstantinos Kostulas1

  • 1Department of Neurology, Karolinska University Hospital, Stockholm, Sweden.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|October 10, 2013
PubMed

Insights

High admission cholesterol levels were linked to better long-term survival after ischemic stroke (IS). This finding helps explain the cholesterol paradox in IS patients, even after accounting for statin use.

Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Biochemistry

Background:

  • Prior statin treatment and high admission cholesterol are paradoxically linked to better outcomes post-ischemic stroke (IS).
  • The exact mechanisms behind this observed paradox remain incompletely understood.
  • Investigating cholesterol's role is crucial for understanding IS prognosis.

Purpose of the Study:

  • To examine the impact of admission cholesterol levels on short- and long-term survival following IS.
  • To evaluate the influence of prior statin treatment on IS outcomes.
  • To clarify the relationship between cholesterol and mortality risk in IS patients.

Main Methods:

  • Analysis of consecutive IS patients admitted in 2006 and 2010.
  • Definition of high total cholesterol as ≥ 4.6 mmol/L.
  • Logistic and Cox regression analyses for 1-month and long-term mortality prediction, respectively.

Main Results:

  • Low cholesterol levels were associated with older age, lower blood pressure, and angina.
  • Patients with high admission cholesterol demonstrated significantly better 1-, 5-, and 7-year survival rates compared to those with low cholesterol (P=.0001).
  • Low cholesterol independently predicted increased mortality risk (adjusted hazard ratio: 1.87; 95% CI: .94-3.32).

Conclusions:

  • High admission cholesterol may be associated with improved long-term survival after ischemic stroke.
  • Further research into the dynamic changes of cholesterol levels and their correlation with stroke outcomes is warranted.
  • These findings contribute to resolving the cholesterol paradox in IS.
Abstract

Keywords:
Brain ischemiacholesterolfatal outcomestatinsstroke

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