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Suboptimal lipid management before and after ischaemic stroke and TIA-the North Dublin Population Stroke Study

Danielle Ní Chróinín1, Chantelle Ní Chróinín2, Layan Akijian3

  • 1Neurovascular Unit for Translational and Therapeutics Research, Mater Misericordiae University Hospital/University College Dublin at Dublin Academic Medical Centre, Dublin 7, Ireland. dmmnic@umail.ucc.ie.

Irish Journal of Medical Science
|January 26, 2018
PubMed

Insights

Lipid-lowering therapy adherence to guidelines is low for stroke and TIA patients. Improved strategies are needed to ensure patients receive recommended lipid management for better outcomes.

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Public Health

Background:

  • Limited population-based research exists on lipid management adherence for stroke/TIA patients.
  • International guidelines exist for primary and secondary prevention in these patient groups.

Purpose of the Study:

  • To evaluate adherence to lipid-lowering therapy (LLT) guidelines in patients experiencing ischaemic stroke or transient ischaemic attack (TIA).

Main Methods:

  • Prospective ascertainment of all stroke and TIA cases in North Dublin City over one year.
  • Assessment of adherence to National Cholesterol Education Programme (NCEP) III guidelines before and after the index event.

Main Results:

  • Only 76.5% had total cholesterol and 60.1% had LDL cholesterol measured post-event.
  • At presentation, 54.1% met NCEP III LDL goals, with adherence linked to comorbidities and prior LLT.
  • Despite 32.7% being on LLT at onset, 21.6% needing treatment were not on it.
  • Post-event, 75.9% received LLT, but 15.3% meeting criteria were not prescribed statins.
  • No association found between initial adherence and 2-year outcomes.

Conclusions:

  • Lipid-lowering therapy recommended by international guidelines is under-utilized in stroke/TIA patients, both before and after an event.
  • There is a clear need for strategies to improve guideline adherence for lipid management in this population.
Abstract

Keywords:
ComplianceHydroxymethylglutaryl-CoA reductase inhibitorsHyperlipidemiaLipidsStroke

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