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Research Article| Volume 378, P26-29, July 15, 2017

Achieving low density lipoprotein-cholesterol<70mg/dL may be associated with a trend of reduced progression of carotid artery atherosclerosis in ischemic stroke patients

Published:April 17, 2017DOI:https://doi.org/10.1016/j.jns.2017.04.024

      Highlight

      • Achieving LDL-c < 70 mg/dL was associated with a trend of reducing atherosclerotic plaque progression at one year.
      • Age (≥60 years) was associated atherosclerotic plaque progression at one year.
      • Gender, diabetes or smoking were not associated atherosclerotic plaque progression at one year.

      Abstract

      Objective

      To assess whether an intensive lipid-lowering strategy is more beneficial on atherosclerotic plaque progression in the stroke survivors.

      Methods

      We retrospectively assessed data that was prospectively collected on 106 ischemic stroke patients from one academic stroke center. Patients with various degrees of common carotid artery atherosclerosis were followed for one year. Patients were classified into intensive lipid-lowering therapy (ILLT) group if they achieve low-density lipoprotein cholesterol (LDL-c) < 70 mg/dL (n = 38) and conventional lipid-lowering therapy (CLLT) group if their LDL-c is within 70–120 mg/dL (n = 68) at end of one year. Carotid ultrasound was performed at baseline lipid-lowering therapy and at one year to characterize the plaques.

      Results

      Mean change in atherosclerotic plaque length was −1.4 mm (95% CI: [−4.1, 1, 2]; P = 0.27) in ILLT and 1.1 mm in CLLP group (95% CI: [−0.9, 3.1]; P = 0.27); no difference between groups (P = 0.40). Atherosclerotic plaque thickness decreased by 0.2 mm (95% CI: [−0.4, 0.03]; P = 0.09) in ILLT group; while in CLLT group, thickness increased by 0.02 mm after 1-year therapy (95%CI: [−0.1, 0.2]; P = 0.77); no difference between groups (P = 0.28).

      Conclusions

      Achieving LDL-c < 70 mg/dL in ischemic stroke patients was associated with a trend of reducing atherosclerotic plaque progression at one year. Future larger studies are warranted.

      Abbreviations:

      LDL-c (low-density lipoprotein cholesterol), ILLT (intensive lipid-lowering therapy), CLLT (conventional lipid-lowering therapy), HCY (homocysteine), S.D. (standard deviation), IQR (interquartile range), CI (confidential interval)

      Keywords

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