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International journal of stroke : official journal of the International Stroke Society

Association of baseline dyslipidemia with stroke recurrence within five-years after ischemic stroke.


PMID 25088494

Abstract

The association between dyslipidemia (DL) and stroke recurrence is unclear, but may be influenced by different subtypes of stroke. This study aims to explore whether DL contributes to the recurrence of certain subtypes of ischemic stroke. Data from the Ege Stroke Registry was examined, and five-years follow-up data for stroke recurrence was analyzed. Trial of Org 10172 in Acute Stroke Treatment criteria was used to classify the subtypes of all stroke. Recurrent stroke was defined as a new neurological deficit compatible to ischemic stroke or intracerebral hemorrhage. The association between DL and stroke recurrence in patients with different sroke subtypes was analyzed using univariable and multivariable logistic regression models. Survival curves were estimated with Kaplan-Meier methods, and survival analyses were undertaken using Cox proportional hazards models. Of the 9940 patients with ischemic stroke, 5838 (58·7%) had DL and 2202 (22·2%) experienced a stroke recurrence within five-years. The frequency of stroke recurrence of patients with DL was unsignificantly higher than those without at five-years of follow-up (18·0% vs. 17·0%; P = 0·21). After stratification by Trial of Org 10172 in Acute Stroke Treatment subtypes, multivariable analysis revealed a significant association between DL and stroke recurrence in all ischemic stroke at five-years (odds ratio, 1·2; 95% confidence interval, 1·02-1·42), and in the large-artery disease subtype (odds ratio, 1·46; 95% confidence interval, 1·12-1·91), but not in the other stroke subtypes (cardioembolic: odds ratio, 1·18; 95% confidence interval, 0·84-1·65; small-artery disease: odds ratio, 1·24; 95% confidence interval, 0·87-1·76; other subtype: odds ratio, 0·79; 95% confidence interval, 0·48-1·31). The probability of stroke recurrence increased in patients with large-artery disease and DL, compared with other subtypes of stroke [log rank test (Mantel-Cox) P < 0·013]. Our results showed that DL is related to the recurrent strokes in patients with ischemic stroke within five-years after ischemic stroke, specifically to the large-artery disease subtype.