Association Between Serum Triglyceride Level and Early Prognosis of Acute Ischemic Stroke

Choi, Kang Ho; Park, Man Seok; Kang, Kyung Wook; Kim, Joon Tae; Choi, Seong Min; Lee, Seung Han; Kim, Byeong Chae; Kim, Myeong Kyu; Cho, Ki Hyun

Abstract

BACKGROUND
Although the association between serum cholesterol levels and cerebrovascular disorder has been extensively studied, the relationship between cholesterol levels and outcome following ischemic stroke remains to be established. We evaluated the association between serum triglyceride levels and the early prognosis of acute ischemic stroke.
METHODS
Among 1096 patients who were admitted to the Neurology department of Chonnam National University Hospital from June 2005 to April 2007, 598 consecutive patients with acute ischemic stroke were enrolled in this study. Patients were divided into five groups based on serum triglyceride levels.
RESULTS
The level of triglyceride was significantly lower in patients with 4 or more improvement in NIHSS score than in patients without improvement (100.4 versus 135.0 mg/dl, p<0.001). In a univariate analysis, thrombolytic therapy (p<0.001), atrial fibrillation (p<0.001), lower total cholesterol (p=0.001), lower LDL cholesterol (p=0.019) and previous statin therapy (p=0.042) were also associated with a better functional outcome. After adjustment for known confounding variables, multivariate and survival analysis showed that a lower triglyceride level above the normal range remained an independent predictor of better functional outcome (p=0.002). Previous statin therapy and thrombolytic therapy were also independent predictors for better functional outcome (p=0.044;p<0.001). However, extremely low triglyceride level (<50.0 mg/dl) was associated with poor functional outcome after an acute ischemic stroke.
CONCLUSIONS
These results suggest that serum triglyceride measurements in acute ischemic stroke could be helpful in predicting clinical improvement. Further prospective studies are required to determine whether triglyceride is an independent predictor for better functional outcome.