Acute-Phase Stroke Outcome and Lipids

Osman Serhat Tokgoz; Figen Guney; Ahmet Kaya; Ahmet Bugrul; Esra Eruyar; Huseyin Buyukgol; Abdullah Seyithanoglu; Mehmet Sinan Iyisoy

doi:10.14744/SEMB.2020.26817

Acute-Phase Stroke Outcome and Lipids

Sisli Etfal Hastan Tip Bul. 2021 Dec 29;55(4):538-544. doi: 10.14744/SEMB.2020.26817. eCollection 2021.

Authors

Osman Serhat Tokgoz¹, Figen Guney¹, Ahmet Kaya², Ahmet Bugrul¹, Esra Eruyar³, Huseyin Buyukgol⁴, Abdullah Seyithanoglu⁵, Mehmet Sinan Iyisoy⁶

Affiliations

¹ Department of Neurology, Necmettin Erbakan University, Meram Medical Faculty, Konya, Turkey.
² Department of Endocrinology, Baskent University Hospital, Konya, Turkey.
³ Department of Neurology, Lokman Hekim Akay Hospital, Ankara, Turkey.
⁴ Department of Neurology, KTO Karatay University, Medical Faculty, Konya Medicana Hospital, Konya, Turkey.
⁵ Department of Neurology, Kahramanmaras, Necip Fazıl City Hospital, Kahramanmaras, Turkey.
⁶ Department of Medical Education and Informatics, Necmettin Erbakan University, Meram Medical Faculty, Konya, Turkey.

Abstract

Objectives: The aim of the study is to investigate the relationship of lipid subgroups with short-term mortality in acute stroke (AS).

Methods: This retrospective study included 698 patients with AS who presented within 24 h of symptom onset. A hemogram from peripheral venous blood samples was taken at admission. Total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), TC/HDL-C rate, and TG/HDL-C rate were recorded. Duration of follow-up was defined as 30 days.

Results: 64 out of 698 patients died during the follow-up period. The mean TG, TG/HDL-C, and TC/HDL-C levels were significantly lower in the mortality group than the survival group. In the receiver operating characteristic (ROC) analysis, the cutoff values and area under the curve of the TG, TG/HDL-C, TC, and TC/HDL-C levels for short-term stroke mortality are as follows ([100.2 mg/dL, 0.648]; [2.52, 0.650]; [170.50 mg/dL, 0.598]; and [4.32, 0.640], respectively). In the Cox regression model, only TG and TG/HDL-C, according to their ROC cutoff values, were independent variables as short-term mortality predictors (TG ≤100.2 mg/dL, HR:2.413 , 95% CI: 1.345-4.327, P:0.004); (TG/HDL ≤2.56, HR: 2.720, 95% CI: 1.389-5.359, P:0.003, respectively).

Conclusion: Dyslipidemia is a well-known as a risk factor of stroke. However, this study focused on the estimation that lower TG and TG/HDL-C levels at the time of hospital admission might be predictors of short-term mortality within a month of AS attack, which is a different subject from long term risk factors of stroke. Serum TG level may be a better indicator for mortality in the acute hypercatabolic trauma such as stroke.

Keywords: Malnutrition; mortality; stroke; triglyceride.