Is higher serum total cholesterol level associated with better long-term functional outcomes after noncardioembolic ischemic stroke?
OBJECTIVE
To investigate the prognostic effects of the serum total cholesterol (TC) levels on long-term functional outcomes in patients with first-time noncardioembolic ischemic stroke.


METHODS
Cohort study.


METHODS
Referral center.


METHODS
Patients (N=109) with first-time ischemic stroke.


METHODS
Not applicable.


METHODS
Serial Barthel Index (BI) scores at onset; 2 weeks; and 1, 2, 4, and 6 months after stroke. We analyzed the impact of the serum TC level and other clinical factors on the repeated measurements of BI scores at these 6 time points by using a linear mixed regression model.


RESULTS
Taking correlation across repeated measurement of BI scores, the TC level, baseline BI, follow-up time, and infarct size were identified as significant predictors for serial BI scores. Higher TC levels correlated with better functional outcomes. A 1-unit (mmol/L) increase in the TC caused a 3.12 (95% confidence interval [CI], .79-5.46) increase in the BI score after controlling for other clinical factors such as age, baseline functional status, and size of infarct. An elevation of 1 unit of baseline BI led to a .49 increase (95% CI, .38-.59) per unit in subsequent BI scores. A small infarct (<1cm) had higher BI scores than larger infarct by 9.09 (95% CI, 2.03-16.16).


CONCLUSIONS
The serum TC level measured at the acute stage of noncardioembolic ischemic stroke is an independent predictor for long-term functional outcomes.
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
Shin-Liang
SL
Pan
I-Nan
IN
Lien
Tony Hsiu-Hsi
TH
Chen
D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D002545:Brain Ischemia / Q000097:blood* / Q000517:prevention & control / Q000534:rehabilitation; D002784:Cholesterol / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D009539:Nicotinic Acids / Q000627:therapeutic use; D011237:Predictive Value of Tests; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D020521:Stroke / Q000097:blood* / Q000517:prevention & control; D000071939:Stroke Rehabilitation; D014665:Vasodilator Agents / Q000627:therapeutic use
D005343:Fibrinolytic Agents; D009539:Nicotinic Acids; D014665:Vasodilator Agents; D002784:Cholesterol; C005392:nicametate; D001241:Aspirin