Effects of low serum triglyceride on stroke mortality: a prospective follow-up study.
BACKGROUND
Low serum triglyceride (TG) has been suggested as a predictor of mortality after cardiovascular disease. However, the relationship between the level of TGs and the outcome after stroke remains to be elucidated. We hypothesized that the influence of TG levels on post-stroke mortality varies according to stroke mechanism: cardioembolic (CE) vs. non-CE causes.


METHODS
We prospectively enrolled a consecutive series of patients with first-ever acute ischemic stroke for 5 years (n=1067), and followed them until the end of 2007 to obtain information on mortality and cause of death. We divided the level of TG into the quartiles, and classified the patients into CE (n=226) and non-CE stroke groups (n=841). The influence of TG level on mortality (all-cause death and vascular death) was examined by univariate and multivariate analyses using Cox regression.


RESULTS
All-cause death and vascular death rates showed inverse relationships to the quartiles of TG levels in all patients (p<0.001, both) and also in non-CE stroke group (p<0.001, both), but not in CE stroke group (p=0.17 and p=0.37, respectively). In the Cox-regression analysis, compared with the highest quartile, the adjusted hazard ratio (HR) of the lowest quartile for all-cause death was 2.58 [95% confidence interval (CI), 1.38-4.82] and that for vascular death was 3.50 (95% CI, 1.39-8.82) in non-CE stroke group. These same associations, however, were not significant in CE stroke group.


CONCLUSIONS
Our results indicate that low serum TG is an independent predictor of mortality after ischemic stroke brought on by non-CE causes.
Ryu
Wi-Sun
WS
Clinical Research Center for Stroke, Clinical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.
Lee
Seung-Hoon
SH
Kim
Chi Kyung
CK
Kim
Beom Joon
BJ
Yoon
Byung-Woo
BW
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000097:blood* / Q000209:etiology / Q000401:mortality*; D002423:Cause of Death; D016009:Chi-Square Distribution; D015536:Down-Regulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000097:blood* / Q000209:etiology / Q000401:mortality*; D013997:Time Factors; D014280:Triglycerides / Q000097:blood*
D015415:Biomarkers; D014280:Triglycerides