Serum Triglyceride Level Is an Important Predictor of Early Prognosis in Patients With Acute Ischemic Stroke

J Neurol Sci. 2012 Aug 15;319(1-2):111-6. doi: 10.1016/j.jns.2012.04.018. Epub 2012 May 12.

Abstract

Background: Some recent studies have shown that poor outcomes after acute ischemic stroke (AIS) were closely related to lower serum triglyceride (TG) levels, not hypertriglyceridemia. However, hypertriglyceridemia has been shown to be an independent predictor for poor outcome in patients with coronary artery disease. This study attempted to evaluate the association between serum TG levels and early prognosis of AIS.

Methods: We enrolled 736 consecutive patients with AIS. Based on the TG level, patients were divided into 5 groups based on the guidelines of the National Cholesterol Education Program (NCEP). We defined early neurological deterioration (END) as a 4-point or greater deterioration of the NIH stroke scale (NIHSS) score and early clinical improvement (ECI) as a 4-point reduction of NIHSS within a week after symptom onset. We compared patients with END, ECI, and neither END nor ECI.

Results: The risk of END was significantly higher in the hyperTG and hypoTG groups compared with the normal group. The percentages of ECI were significantly lower in the hypoTG, borderline, and hyperTG groups compared with the normal group. For END, the multivariable adjusted odds ratios were significantly higher in the hypoTG, borderline, and hyperTG groups compared with the low normal group (50 to 100mg/dl).

Conclusions: TG had a nonlinear, J-shaped association with poor outcome and a reverse J-shaped association with good outcome in AIS. This study suggests that both hyperTG and hypoTG can be risk factors for poor early outcome in AIS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brain Ischemia / blood
  • Brain Ischemia / diagnosis*
  • Brain Ischemia / drug therapy
  • Female
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Severity of Illness Index
  • Stroke / blood
  • Stroke / diagnosis*
  • Stroke / drug therapy
  • Tissue Plasminogen Activator / therapeutic use
  • Treatment Outcome
  • Triglycerides / blood*

Substances

  • Fibrinolytic Agents
  • Triglycerides
  • Tissue Plasminogen Activator