title: When to measure lipid profile after stroke?
abstract: BACKGROUND
  Although acute decreases in total cholesterol (TC) are well documented in myocardial infarction, previous stroke studies have produced conflicting results. The timing of lipid estimation in ischemic stroke is becoming important with recent trial results indicating the benefits of statins. We therefore aimed to determine the optimal time for lipid measurements after stroke. We hypothesized that TC would acutely decrease after stroke and return to baseline by 12 weeks.
  
  
  RESULTS
  We performed a prospective, observational study of 50 patients (age 68.5 +/- 11.2 years) who presented with acute ischemic stroke. Of these, 22 (44%) were HMG-CoA reductase (statin) naïve, 15 (30%) had already been on statins and 13 (26%) were commenced on statins. Of the 50 patients, 38 (76%) completed 12 weeks of follow-up, 5 died, and 7 were lost to follow-up. Fasting lipid profile (TC, low-density lipoprotein, high-density lipoprotein, triglyceride) was measured <48 h, 4 weeks and 12 weeks following ictus. In patients who were statin naïve, there was a significant increase in TC at the week 12 evaluation.
  
  
  CONCLUSIONS
  Cholesterol levels in acute stroke are an unreliable measure of lipid status. Initiation of statins should ideally be based on measurements taken 12 weeks after stroke.
authors.affiliation: Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia.
authors.forename: Bernard
authors.initials: B
authors.lastname: Yan
authors.forename: Mark
authors.initials: M
authors.lastname: Parsons
authors.forename: Sharyn
authors.initials: S
authors.lastname: McKay
authors.forename: Donald
authors.initials: D
authors.lastname: Campbell
authors.forename: Bernard
authors.initials: B
authors.lastname: Infeld
authors.forename: Raymond
authors.initials: R
authors.lastname: Czajko
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Davis
mesh_terms: D000208:Acute Disease; D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D002624:Chemistry, Clinical / Q000592:standards*; D002784:Cholesterol / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D020521:Stroke / Q000097:blood*; D013997:Time Factors
chemical_list: D000924:Anticholesteremic Agents; D002784:Cholesterol