Zhao Lu, Wang Ruihao, Song Bo, Tan Song, Gao Yuan, Fang Hui, Lu Jie, Xu Yuming
Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany.
Int J Stroke. 2015 Jul;10(5):752-8. doi: 10.1111/ijs.12471. Epub 2015 Apr 28.
The association between atherogenic dyslipidemia and stroke recurrence remains unclear, and may be influenced by different subtypes of ischemic stroke.
We aimed to investigate whether atherogenic dyslipidemia contributed to stroke recurrence in ischemic stroke patients and in those with certain subtypes of ischemic stroke.
We conducted a prospective hospital-based study enrolling patients with acute ischemic stroke. Atherogenic dyslipidemia was defined as high-density lipoprotein cholesterol <40 mg/dl and triglycerides ≥200 mg/dl. Ischemic stroke subtypes were classified according to the Trial of Org 10172 in Acute Stroke Treatment criteria. The patients were followed up at 3, 6, 12 and 24 months after stroke onset. The association between atherogenic dyslipidemia and stroke recurrence was analyzed by using multivariable Cox regression model.
In the 510 ischemic stroke patients, 64 patients (12·5%) had atherogenic dyslipidemia, and 66 patients (12·9%) experienced stroke recurrence events within 24 months. Kaplan-Meier analysis revealed that stroke recurrence rate was significantly higher in patients with atherogenic dyslipidemia than those without in all the stroke patients (20·3% vs. 11·9%; P = 0·048), and more evident in those of large-artery atherosclerosis subtype (31·0% vs. 14·1%; P = 0·014), but not in the other subtypes. Multivariable Cox regression analysis revealed that atherogenic dyslipidemia was associated with higher stroke recurrence risk among stroke patients of large-artery atherosclerosis subtype (hazard ratio, 2·79; 95% confidence interval, 1·24-6·28), but not significant in all the stroke patients (hazard ratio, 1·69; 95% confidence interval, 0·85-3·37).
Atherogenic dyslipidemia is associated with higher risk of stroke recurrence in ischemic stroke patients. Such association might be more pronounced in large-artery atherosclerosis subtype and needs further investigation to establish such relationship.
动脉粥样硬化性血脂异常与卒中复发之间的关联尚不清楚，且可能受缺血性卒中不同亚型的影响。
我们旨在研究动脉粥样硬化性血脂异常是否会导致缺血性卒中患者以及某些缺血性卒中亚型患者的卒中复发。
我们开展了一项基于医院的前瞻性研究，纳入急性缺血性卒中患者。动脉粥样硬化性血脂异常定义为高密度脂蛋白胆固醇<40mg/dl且甘油三酯≥200mg/dl。缺血性卒中亚型根据急性卒中治疗中Org 10172试验标准进行分类。患者在卒中发作后3、6、12和24个月进行随访。采用多变量Cox回归模型分析动脉粥样硬化性血脂异常与卒中复发之间的关联。
在510例缺血性卒中患者中，64例（12.5%）患有动脉粥样硬化性血脂异常，66例（12.9%）在24个月内发生了卒中复发事件。Kaplan-Meier分析显示，在所有卒中患者中，动脉粥样硬化性血脂异常患者的卒中复发率显著高于无此异常的患者（20.3%对11.9%；P=0.048），在大动脉粥样硬化亚型患者中更为明显（31.0%对14.1%；P=0.014），但在其他亚型中并非如此。多变量Cox回归分析显示，在大动脉粥样硬化亚型的卒中患者中，动脉粥样硬化性血脂异常与较高的卒中复发风险相关（风险比，2.79；95%置信区间，1.24-6.28），但在所有卒中患者中不显著（风险比，1.69；95%置信区间，0.85-3.37）。
动脉粥样硬化性血脂异常与缺血性卒中患者较高的卒中复发风险相关。这种关联在大动脉粥样硬化亚型中可能更明显，需要进一步研究以确定这种关系。
