Age, HDL cholesterol linked to ischemic stroke risk
MedWire News: Older age and lower levels of high-density lipoprotein (HDL) cholesterol are independent risk factors for ischemic stroke recurrence, say researchers.
Determining such risk factors is important for improving management of stroke survivors, as ischemic stroke recurs in a significant proportion - around 8-12%.
The team, led by Hiroshi Sugimori from Kyushu University in Fukuoka, Japan, analyzed clinical characteristics of 260 acute (within 7 days of onset) ischemic stroke patients registered in the Fukuoka Stroke Registry (FSR) between June 2007 and April 2008, to assess possible links with recurrence.
Over the 12-month follow-up period, 25 patients (9.6%) suffered a recurrence of ischemic stroke.
The researchers found that those who suffered recurrence had higher frequencies of previous ischemic stroke than those who did not (40% vs 22%, respectively). They also more frequently had low levels of HDL cholesterol (below 40 mg/dl [1.04 mmol/l]) on admission (33% vs 16%) and were of older age (74.5 vs 70.5 years).
There were significant differences in recurrence-free survival rates between patients with HDL cholesterol levels below 40 mg/dl and at or above 40 mg/dl on admission, at 92.5% versus 82.5%, respectively.
Furthermore, analysis revealed that HDL cholesterol levels and age were both independent risk factors for stroke recurrence. Patients with HDL levels less than 40 mg/dl, compared with levels at or above 40 mg/dl, were at a 2.73-fold increased risk for recurrence, while each 1-year increase in age increased the risk for recurrent stroke by 6%.
The authors say that while low-density lipoprotein cholesterol is often the primary goal for lipid modifying coronary heart disease interventions, their results suggest that HDL cholesterol should be a main dyslipidemia treatment target for stroke recurrence in randomized controlled trials.
They conclude: "For patients with low HDL cholesterol levels, clinical trials evaluating the effect of HDL cholesterol-raising therapy for prevention of recurrent stroke may be warranted."
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By Nikki Withers