Related Experiment Video
Updated: Oct 21, 2025
A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
Atherogenic Dyslipidemia and Residual Vascular Risk After Stroke or Transient Ischemic Attack
Takao Hoshino1, Kentaro Ishizuka1, Sono Toi1
1Department of Neurology, Tokyo Women's Medical University Hospital, Japan.
Insights
Atherogenic dyslipidemia (AD) significantly increases the risk of major adverse cardiovascular events and stroke after an initial vascular event. Targeting AD is crucial for secondary stroke prevention.
Area of Science:
- Cardiology
- Neurology
- Vascular Medicine
Background:
- Despite current guidelines, stroke patients face significant residual risk of vascular events.
- Atherogenic dyslipidemia (AD) is a potential contributor to this residual risk.
Purpose of the Study:
- To evaluate the role of atherogenic dyslipidemia (AD) in the residual vascular risk among patients post-stroke or transient ischemic attack (TIA).
Main Methods:
- Prospective observational study of 792 patients within 1 week of ischemic stroke or TIA, followed for 1 year.
- AD defined by elevated triglycerides (≥150 mg/dL) and low HDL-C (<40 mg/dL men, <50 mg/dL women).
- Primary outcome: composite of major adverse cardiovascular events (MACE), including nonfatal stroke, nonfatal acute coronary syndrome, and vascular death.
Main Results:
- AD prevalence was 12.2% and associated with higher intracranial artery stenosis.
- Patients with AD had a significantly greater risk of MACE (24.5% vs 10.6%) and ischemic stroke (16.8% vs 8.6%) at 1 year.
- AD predicted MACE across all baseline LDL-C levels, particularly in those with LDL-C <100 mg/dL.
Conclusions:
- Atherogenic dyslipidemia is linked to intracranial atherosclerosis and elevated residual vascular risk post-stroke/TIA.
- AD represents a promising, modifiable target for enhancing secondary stroke prevention strategies.
Background And Purpose:
Notwithstanding the current guideline-based management, patients with stroke retain a substantial risk of further vascular events. We aimed to assess the contribution of atherogenic dyslipidemia (AD) to this residual risk.
Methods:
This was a prospective observational study, in which 792 patients (mean age, 70.1 years; male, 60.2%) with acute ischemic stroke (n=710) or transient ischemic attack (n=82) within 1 week of onset were consecutively enrolled and followed for 1 year. AD was defined as having both elevated levels of triglycerides ≥150 mg/dL and low HDL-C (high-density lipoprotein cholesterol) <40 mg/dL in men or <50 mg/dL in women, under fasting conditions. The primary outcome was a composite of major adverse cardiovascular events, including nonfatal stroke, nonfatal acute coronary syndrome, and vascular death.
Results:
The prevalence of AD was 12.2%. Patients with AD more often had intracranial artery stenosis than those without (42.3% versus 24.1%; P=0.004), whereas no differences were observed in the prevalence of extracranial artery stenosis (17.7% versus 12.9%; P=0.62) or aortic plaques (33.3% versus 27.0%; P=0.87). At 1 year, patients with AD were at a greater risk of major adverse cardiovascular events (annual rate, 24.5% versus 10.6%; hazard ratio [95% CI], 2.33 [1.44-3.80]) and ischemic stroke (annual rate, 16.8% versus 8.6%; hazard ratio [95% CI], 1.84 [1.04-3.26]) than those without AD. When patients were stratified according to baseline LDL-C (low-density lipoprotein cholesterol) level, AD was predictive of major adverse cardiovascular events among those with LDL-C ≥100 mg/dL (n=509; annual rate, 20.5% versus 9.6%; P=0.036) as well as those with LDL-C <100 mg/dL (n=283; annual rate, 38.6% versus 12.4%; P<0.001).
Conclusions:
AD is associated with intracranial artery atherosclerosis and a high residual vascular risk after a stroke or transient ischemic attack. AD should be a promising modifiable target for secondary stroke prevention. Registration: URL: https://upload.umin.ac.jp; Unique identifier: UMIN000031913.
Related Concept Videos
01:26Atherosclerosis III: Management
01:30Atherosclerosis I: Introduction
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
01:20Lipid-Lowering Drugs: Statins and Miscellaneous Agents
01:25Blood Studies for Cardiovascular System III: Serum Lipid Profile
Serum lipids are fats and fatty substances in the blood and are crucial for various bodily functions, including energy storage, cellular structure, and hormone production. Serum lipids consist of cholesterol, triglycerides, and phospholipids.
Cholesterol is a soft, fat-like substance found in all body cells. It is crucial for producing hormones, vitamin D, and substances that aid...
01:27Atherosclerosis II: Clinical Manifestations and Diagnostic Tests