Lipid management in ischemic stroke patients.
OBJECTIVE
In-hospital initiation and maintaining of lipid-lowering therapy (LLT) after discharge is recommended for dyslipidemic stroke patients. However, little is known about actual adherence to treatment in Taiwan. This study aims to describe the current practice of lipid testing and LLT and to identify predictors for patient to receive LLT.


METHODS
Between February 2001 and December 2002, a total of 1105 consecutive ischemic stroke patients were prospectively registered. Dyslipidemic ischemic stroke patients were recruited and followed over a 6 months period.


RESULTS
In-hospital lipid testing was performed in 91% of all patients and LLT was initiated in 74% (350/476) of dyslipidemic patients. During the 6 months follow-up period, lipid testing was performed in 77% (266/345) and LLT was maintained in 45% (154/345) of patients. However, the target LDL cholesterol level (<100mg/dL) was achieved in only 30% (78/255) of patients. Older patients had a lower chance to receive LLT.


CONCLUSIONS
The in-hospital initiation of LLT and lipid testing was considered adequate as compared to other studies. However, after discharge from the hospital, many patients, especially older patients remained untreated. Efforts to close treatment gaps in lipid management require sustained quality improvement efforts. More awareness in this area is needed.
Tan
Teng-Yeow
TY
Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan. tengyeowtan@yahoo.com
Chang
Ku-Chou
KC
Schminke
Ulf
U
Lin
Tsung-Kung
TK
Huang
Yu-Ching
YC
Hung
Jen-Wen
JW
Chen
Ting-Yao
TY
D000368:Aged; D002545:Brain Ischemia / Q000097:blood / Q000150:complications / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012189:Retrospective Studies; D020521:Stroke / Q000097:blood / Q000209:etiology / Q000628:therapy*; D013624:Taiwan
D000960:Hypolipidemic Agents