Cholesterol Levels Are Associated with 30-day Mortality from Ischemic Stroke in Dialysis Patients

J Stroke Cerebrovasc Dis. 2017 Jun;26(6):1349-1356. doi: 10.1016/j.jstrokecerebrovasdis.2017.02.007. Epub 2017 Mar 21.

Abstract

Background: We investigated the impact of serum cholesterol levels on 30-day mortality after ischemic stroke in dialysis patients.

Methods: From the Taiwan Stroke Registry data, we identified 46,770 ischemic stroke cases, including 1101 dialysis patients and 45,669 nondialysis patients from 2006 to 2013.

Results: Overall, the 30-day mortality was 1.46-fold greater in the dialysis group than in the nondialysis group (1.75 versus 1.20 per 1000 person-days). The mortality rates were 1.64, .62, 2.82, and 2.23 per 1000 person-days in dialysis patients with serum total cholesterol levels of <120 mg/dL, 120-159 mg/dL, 160-199 mg/dL, and ≥200 mg/dL, respectively. Compared to dialysis patients with serum total cholesterol levels of 120-159 mg/dL, the corresponding adjusted hazard ratios of mortality were 4.20 (95% confidence interval [CI] = 1.01-17.4), 8.06 (95% CI = 2.02-32.2), and 6.89 (95% CI = 1.59-29.8) for those with cholesterol levels of <120 mg/dL, 160-199 mg/dL, and ≥200 mg/dL, respectively.

Conclusions: Dialysis patients with serum total cholesterol levels of ≥160 mg/dL or <120 mg/dL on admission are at an elevated hazard of 30-day mortality after ischemic stroke.

Keywords: Cholesterol; dialysis; ischemic stroke, mortality; prognosis.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Brain Ischemia / blood*
  • Brain Ischemia / diagnosis
  • Brain Ischemia / mortality*
  • Cholesterol / blood*
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / mortality
  • Kidney Failure, Chronic / therapy
  • Male
  • Middle Aged
  • Patient Admission
  • Prognosis
  • Proportional Hazards Models
  • Registries
  • Renal Dialysis / adverse effects
  • Renal Dialysis / mortality
  • Risk Factors
  • Stroke / blood*
  • Stroke / diagnosis
  • Stroke / mortality*
  • Taiwan / epidemiology
  • Time Factors

Substances

  • Biomarkers
  • Cholesterol