title: Low levels of high-density lipoprotein cholesterol in patients with atherosclerotic stroke: a prospective cohort study.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the influence of baseline high-density lipoprotein cholesterol (HDL-C) on initial stroke severity and clinical outcomes in acute ischemic stroke.
  
  
  METHODS
  From August 2006 through December 2011, patients with acute atherosclerotic ischemic stroke were included. Total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C) and HDL-C were checked and National Institutes of Health Stroke Scale (NIHSS) scores were obtained at admission. The primary outcomes were a composite end point of all-cause mortality, recurrent stroke, or occurrence of ischemic heart disease during follow-up.
  
  
  RESULTS
  Overall, 3093 subjects (mean age 66.8 years) were included and 675 patients (22%) had low HDL-C (≤35 mg/dL) at admission. These patients had higher NIHSS scores. After adjusting for all clinical factors in multivariate logistic analysis, low HDL-C at admission (OR, 1.79, 95% CI, 1.40-2.29) was significantly associated with higher stroke severity (NIHSS score > 6). During the follow-up period, 280 patients (9%) developed one of the components of the composite end point, including 76 (11.3%) in patients with low HDL-C and 204 (8.4%) in patients with normal HDL-C at admission (p < 0.001). In multivariate Cox regression analysis, after adjusting for all clinical factors, low HDL-C at admission (HR, 1.41, 95% CI, 1.02-1.95) was a significant independent predictor of the composite end point.
  
  
  CONCLUSIONS
  Low baseline HDL-C (≤35 mg/dL) at admission was associated with higher stroke severity and poor clinical outcome during follow-up in patients with atherosclerotic ischemic stroke.
authors.affiliation: Department of Neurology, Chi Mei Medical Center, Tainan, Taiwan.
authors.forename: Poh-Shiow
authors.initials: PS
authors.lastname: Yeh
authors.forename: Chun-Ming
authors.initials: CM
authors.lastname: Yang
authors.forename: Sheng-Hsiang
authors.initials: SH
authors.lastname: Lin
authors.forename: Wei-Ming
authors.initials: WM
authors.lastname: Wang
authors.forename: Po-Sheng
authors.initials: PS
authors.lastname: Chen
authors.forename: Ting-Hsing
authors.initials: TH
authors.lastname: Chao
authors.forename: Huey-Juan
authors.initials: HJ
authors.lastname: Lin
authors.forename: Kao-Chang
authors.initials: KC
authors.lastname: Lin
authors.forename: Chia-Yu
authors.initials: CY
authors.lastname: Chang
authors.forename: Tain-Junn
authors.initials: TJ
authors.lastname: Cheng
authors.forename: Yi-Heng
authors.initials: YH
authors.lastname: Li
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000097:blood* / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000097:blood / Q000209:etiology; D016017:Odds Ratio; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000097:blood* / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D013997:Time Factors; D014280:Triglycerides / Q000097:blood
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides