Eicosapentaenoic Acid as long-term secondary prevention after ischemic stroke

It is sometimes difficult to choose anti-thrombotic agents for secondary prevention in stroke patients at high bleeding risk. Recently, Eicosapentaenoic Acid (EPA) was reported to reduce the recurrence of stroke in hypercholesterolemic patients without increasing hemorrhagic risk. In this study, we investigated the features of recurrent stroke patients during EPA medication as secondary stroke prevention.

Following the approval of the ethical committee, stroke patients in the outpatient clinic were consecutively screened and patients who continuously take EPA were enrolled in this study (n = 71, average age 69.7 yo). Blood sample data was adopted from the latest visit or the admission at the stroke recurrence. According to the previous stroke history, all patients were classified into the hemorrhagic stroke (HS) group (n = 10) and the ischemic stroke, including asymptomatic infarction, (IS) group (n = 61).

Any stroke recurrence was not observed in the HS group. Whereas, ischemic stroke recurrence was observed in 6 patients in the IS group, although there was no hemorrhagic stroke recurrence. Recurrent stroke patients showed the higher serum level of cholesterol or the renal dysfunction. The stroke subtype of patients were 2 embolic strokes, 3 atherothrombotic infarctions (two were compromised with renal failure and one had insufficient amount of EPA) and one lacunar infarction (who showed high triglyceride level).

Hemorrhagic stroke was not occurred in our observation of EPA prescribed patients. The clinical features of recurrent stroke patients were the existing complications of dyslipidemia and renal dysfunction.