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A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis
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A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis

Published on: August 12, 2025

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Association Between Total Cholesterol and 5 year Mortality in Patients with Carotid Artery Stenosis and Poststroke

Yen-Ju Lung1, Wei-Chieh Weng1, Chia-Lun Wu1

  • 1Department of Neurology, Chang-Gung Memorial Hospital, Keelung branch, Keelung, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|January 16, 2019
PubMed

Insights

Lower total cholesterol levels increase 5-year mortality risk in ischemic stroke patients with severe carotid artery stenosis and functional dependence. Careful consideration of aggressive lipid-lowering treatment is advised for this patient group.

Area of Science:

  • Neurology
  • Cardiology
  • Public Health

Background:

  • Aggressive lipid-lowering treatment is debated in stroke patients.
  • High-grade internal carotid artery (ICA) stenosis and functional dependence are key factors in stroke outcomes.

Purpose of the Study:

  • To investigate the impact of total cholesterol levels on 5-year outcomes in ischemic stroke patients with high-grade ICA stenosis and post-stroke functional dependence.

Main Methods:

  • 196 acute ischemic stroke patients with high-grade ICA stenosis and modified Rankin Scale score ≥ 3 were observed for 5 years.
  • Patients were grouped by admission total cholesterol levels: ≥200 mg/dL or <200 mg/dL.
  • Demographics, vascular risk factors, comorbidities, and outcomes were compared between groups.

Main Results:

  • Lower total cholesterol (<200 mg/dL) was associated with higher prevalence of older age and atrial fibrillation.
  • Higher total cholesterol (≥200 mg/dL) was linked to a higher prevalence of diabetes mellitus.
  • Multivariate analysis revealed lower total cholesterol as a significant predictor of 5-year mortality (HR=1.88, P=.023).

Conclusions:

  • Lower total cholesterol levels are linked to increased 5-year mortality in ischemic stroke patients with high-grade ICA stenosis and functional dependence.
  • Aggressive hyperlipidemia treatment requires careful consideration in this specific patient population.
  • While aggressive treatment may benefit some, its impact on mortality in this group warrants caution.
Abstract

Keywords:
Total cholesterolcarotid artery stenosisfunctional dependenceischemic strokelower cholesterolmortalitystroke outcome

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