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U-curve relation between cholesterol and prior ischemic stroke.

Gerd Haga Bringeland1, Aliona Nacu2, Ulrike Waje-Andreassen3

  • 1Department of Neurology Haukeland University Hospital Bergen Norway.

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|November 16, 2016
PubMed
Summary

Cholesterol levels and prior ischemic stroke risk show a U-shaped association in acute ischemic stroke patients. Lower cholesterol (<5.5 mmol/L) correlated with higher prior stroke risk, even in statin-naive individuals.

Keywords:
cholesterolischemic strokereverse epidemiologystatinstroke recurrencevascular risk factors

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Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Epidemiology

Background:

  • Previous studies on cholesterol and ischemic stroke outcomes yielded conflicting results.
  • Understanding the relationship between cholesterol levels and a history of ischemic stroke is crucial for patient management.

Purpose of the Study:

  • To investigate the association between cholesterol levels on admission and the occurrence of prior ischemic stroke in acute ischemic stroke patients.
  • To test the hypothesis that higher cholesterol levels are associated with a greater frequency of prior ischemic stroke.

Main Methods:

  • Prospective registration of consecutive acute ischemic stroke patients in The Bergen NORSTROKE Registry (February 2006 - October 2013).
  • Measurement of cholesterol, LDL, and HDL on admission; registration of prior ischemic stroke, risk factors, and medications.
  • Comparison of patients with and without prior ischemic stroke, including analysis of statin use and cholesterol levels.

Main Results:

  • A U-curve relationship was observed between cholesterol levels and the relative frequency of prior ischemic stroke.
  • Lower cholesterol levels (up to 5.5 mmol/L) were associated with a lower frequency of prior ischemic stroke.
  • For cholesterol levels above 5.5 mmol/L, higher levels were associated with a higher frequency of prior ischemic stroke, an association also seen in statin-naive patients.

Conclusions:

  • The study's initial hypothesis was not supported.
  • The association between lower cholesterol and higher prior ischemic stroke frequency is not solely attributable to statin use.
  • Cholesterol levels exhibit a complex, non-linear relationship with the history of ischemic stroke.