Low triglycerides predict death after noncardioembolic ischemic stroke
MedWire News: Low serum levels of triglycerides independently predict the risk for death after ischemic stroke from noncardioembolic (non-CE) causes, a prospective follow-up study suggests.
In contrast, triglyceride levels do not predict mortality in patients with stroke brought on by CE causes, suggest the findings published in the journal Atherosclerosis.
The researchers, from the Republic of Korea, say: “To our knowledge, this is the first study to show that low levels of triglycerides have differential risks for mortality according to stroke etiology.”
The team recruited 1143 consecutive patients admitted to their stroke unit within 48 hours of a first-ever acute ischemic stroke between October 2002 and September 2007.
Of these, 40 had stroke etiologies not applicable to the study, such as vasculitis, arterial dissection, or moyamoya disease, and a further 36 had insufficient medical and triglyceride information, leaving 1067 individuals who were followed-up until the end of 2007.
All-cause and vascular death rates showed an inverse relationship with quartiles of triglyceride levels in all patients and also in the 841 patients with stroke from non-CE causes.
However, this was not the case for the 226 patients with stroke from CE causes.
In Cox-regression analysis, the adjusted hazard ratio for the highest (1.67 mmol/l, 147.9 mg/dl) versus the lowest (<0.87 mmol/l, 77.1 mg/dl) triglyceride quartile in the non-CE stroke group was 2.58 for all-cause death and 3.50 for vascular death. The same associations were not statistically significant in the CE group.
Seung-Hoon Lee and colleagues at the Seoul National University Hospital conclude: “Our study demonstrated that low triglyceride levels are an independent predictor of post-stroke mortality, especially in non-CE stroke patients.”
But they add that the recent failure of a triglyceride-lowering clinical trial suggests that triglycerides may differ from low-density lipoprotein cholesterol with respect to the pathologic or physiologic process of vascular disease.
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By Anita Wilkinson