Is higher serum total cholesterol level associated with better long-term functional outcomes after noncardioembolic ischemic stroke?

OBJECTIVE

To investigate the prognostic effects of the serum total cholesterol (TC) levels on long-term functional outcomes in patients with first-time noncardioembolic ischemic stroke.

DESIGN

Cohort study.

SETTING

Referral center.

PARTICIPANTS

Patients (N=109) with first-time ischemic stroke.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURE

Serial Barthel Index (BI) scores at onset; 2 weeks; and 1, 2, 4, and 6 months after stroke. We analyzed the impact of the serum TC level and other clinical factors on the repeated measurements of BI scores at these 6 time points by using a linear mixed regression model.

RESULTS

Taking correlation across repeated measurement of BI scores, the TC level, baseline BI, follow-up time, and infarct size were identified as significant predictors for serial BI scores. Higher TC levels correlated with better functional outcomes. A 1-unit (mmol/L) increase in the TC caused a 3.12 (95% confidence interval [CI], .79-5.46) increase in the BI score after controlling for other clinical factors such as age, baseline functional status, and size of infarct. An elevation of 1 unit of baseline BI led to a .49 increase (95% CI, .38-.59) per unit in subsequent BI scores. A small infarct (<1cm) had higher BI scores than larger infarct by 9.09 (95% CI, 2.03-16.16).

CONCLUSIONS

The serum TC level measured at the acute stage of noncardioembolic ischemic stroke is an independent predictor for long-term functional outcomes.