Abstract
Background
Reduced serum high-density lipoprotein (HDL-C) is an independent risk factor for ischemic
stroke in elderly men. The temporal and quantitative relationships between HDL-C and
acute ischemic stroke have not been defined.
Methods
We identified patients with first ever acute ischemic stroke presenting to our hospital
between 2003 and 2006. Patients with serum fasting lipid levels drawn within 24 h
of admission and at least one follow-up visit with a neurologist in our hospital were
included. Clinical and laboratory data before, immediately after, and several weeks
after the index stroke were collected.
Results
191 patients were included (47% women, mean age 62 years). The mean time interval
between pre-stroke lipid data and index stroke was 5.2 months; 50% of these patients
were taking a statin medication. The mean time interval between index stroke and follow-up
lipid testing was 2.6 months. Immediately after the index stroke, HDL-C levels decreased
by 18% (p<0.001) relative to pre-stroke levels. This phenomenon was independent of stroke severity,
and was blunted among patients with a prior history of myocardial infarction (p<0.01). HDL-C levels increased to pre-stroke levels within 3 months post-stroke.
Conclusions
HDL-C levels decrease significantly at the time of acute ischemic stroke. Prior history
of myocardial infarction diminishes HDL-C depression at the time of stroke. HDL-C
may be an acute phase reactant or nascent biomarker of acute stroke susceptibility.
Further prospective studies are needed.
Keywords
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Article info
Publication history
Published online: February 06, 2009
Accepted:
December 16,
2008
Received in revised form:
November 11,
2008
Received:
May 15,
2008
Identification
Copyright
© 2008 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
