Blood lipids in brain infarction subtypes.
BACKGROUND
Little is known about the relationship between hypercholesterolaemia and specific aetiological subtypes of brain infarction (BI).


METHODS
In a cross-sectional study of 492 pairs of patients with a BI proven by MRI and matched hospital controls, we determined the blood levels of triglycerides, total, HDL and LDL cholesterol, and apolipoprotein A(1) and B, in the same centralized laboratory. We performed aetiological BI subtype classification.


RESULTS
Except for triglycerides, the risk of BI increased continuously with the lipid levels, without any heterogeneity between the main BI subtypes or the group on lipid-lowering therapy. The adjusted odds ratio per standard deviation in LDL cholesterol (0.93 mmol/l) was 1.74 (95% confidence interval, 1.02-2.98) in atherothrombotic strokes (n = 109) and 2.71 (95% confidence interval, 1.60-4.55) in lacunar strokes (n = 105). Eighty percent of patients were above the ATP-III guideline threshold LDL cholesterol of 2.59 mmol/l (100 mg/dl), with a major contribution of both atherothrombotic and lacunar stroke subtypes to this group.


CONCLUSIONS
These findings suggest that blood lipids, particularly total and LDL cholesterol levels, are associated with all subtypes of BI, and that LDL above 2.59 mmol/l is highly prevalent.
Amarenco
Pierre
P
Department of Neurology and Stroke Centre, Bichat Hospital, Denis Diderot University, INSERM U-360, Paris, France. pierre.amarenco@bch.aphp.fr
Labreuche
Julien
J
Elbaz
Alexis
A
Touboul
Pierre-Jean
PJ
Driss
Fathi
F
Jaillard
Assia
A
Bruckert
Eric
E