Department of Neurology, County Hospital Varaždin, Varaždin, Croatia.
J Stroke Cerebrovasc Dis. 2013 Oct;22(7):e15-24. doi: 10.1016/j.jstrokecerebrovasdis.2012.03.006. Epub 2012 Apr 13.
High(er) on-admission triglyceride (TG) levels have been suggested as an independent predictor of better outcomes of the acute ischemic stroke. Data regarding poststroke physical disabilities have been contradictory. We aimed to investigate the relationship between fasting on-admission TG and development of disability and all-cause mortality over a 2.5-year period.
This prospective observational study included 83 acute ischemic stroke patients (29 cardioembolic; 41% men; median age 76 years) followed-up for 28 to 30 months and assessed for physical disability using the Modified Rankin scale (mRS) at 1 week and 3, 12, and 24 months poststroke. TGs were considered as a continuous and a binary variable (≤ 1.27 [n = 43] and >1.27 mmol/L [n = 43]).
Higher TGs (continuous or binary) were independently (default adjustments: stroke type, severity at presentation, age, atrial fibrillation, preindex event antiplatelet use, infarct volume, postindex event antiplatelet, statin and angiotensin-converting enzyme inhibitor use, on-admission fasting cholesterol, mean platelet volume, and glomerular filtration rate) were associated with: (1) higher odds of mRS 0 to 2 (none/mild disability) across the assessments (overall odds ratio [OR] 2.73 [95% confidence interval {CI} 1.15-6.38] and OR 3.57 [95% CI 1.04-12.3], respectively); (2) lower odds of mRS worsening between any 2 consecutive assessments (overall OR 0.44 [95% CI 0.20-0.96] and OR 0.35 [95% CI 0.16-0.77], respectively); (3) lower risk of all-cause mortality (hazard ratio 0.47 [95% CI 0.23-0.96] and hazard ratio 0.45 [95% CI 0.21-0.98], respectively).
These data suggest that higher fasting TGs on-admission predict less severe disability, reduced disability progression, and all-cause mortality in patients with acute ischemic stroke.
较高的入院时甘油三酯（TG）水平被认为是急性缺血性脑卒中患者更好结局的独立预测因素。关于卒中后身体残疾的数据存在矛盾。我们旨在研究空腹入院时 TG 与 2.5 年内残疾和全因死亡率的关系。
这项前瞻性观察性研究纳入了 83 名急性缺血性脑卒中患者（29 例心源性栓塞；41%为男性；中位年龄 76 岁），随访 28 至 30 个月，采用改良 Rankin 量表（mRS）在卒中后 1 周和 3、12 和 24 个月评估身体残疾情况。TG 被视为连续变量和二分变量（≤ 1.27[n = 43]和>1.27mmol/L[n = 43]）。
较高的 TG（连续或二分）在默认调整后（卒中类型、发病时严重程度、年龄、心房颤动、预指数事件抗血小板治疗、梗死体积、后指数事件抗血小板治疗、他汀类药物和血管紧张素转换酶抑制剂的使用、入院时空腹胆固醇、血小板平均体积和肾小球滤过率）与以下方面独立相关：（1）mRS 0 至 2 分（无/轻度残疾）的比例较高（总体优势比[OR]2.73[95%置信区间{CI}1.15-6.38]和 OR 3.57[95%CI 1.04-12.3]）；（2）mRS 在任何两次连续评估之间恶化的几率较低（总体 OR 0.44[95%CI 0.20-0.96]和 OR 0.35[95%CI 0.16-0.77]）；（3）全因死亡率风险较低（风险比 0.47[95%CI 0.23-0.96]和风险比 0.45[95%CI 0.21-0.98]）。
这些数据表明，急性缺血性脑卒中患者入院时较高的空腹 TG 预测残疾程度较轻、残疾进展减少和全因死亡率降低。
