Cholesterol Levels Are Associated with 30-day Mortality from Ischemic Stroke in Dialysis Patients.
BACKGROUND
We investigated the impact of serum cholesterol levels on 30-day mortality after ischemic stroke in dialysis patients.


METHODS
From the Taiwan Stroke Registry data, we identified 46,770 ischemic stroke cases, including 1101 dialysis patients and 45,669 nondialysis patients from 2006 to 2013.


RESULTS
Overall, the 30-day mortality was 1.46-fold greater in the dialysis group than in the nondialysis group (1.75 versus 1.20 per 1000 person-days). The mortality rates were 1.64, .62, 2.82, and 2.23 per 1000 person-days in dialysis patients with serum total cholesterol levels of <120 mg/dL, 120-159 mg/dL, 160-199 mg/dL, and ≥200 mg/dL, respectively. Compared to dialysis patients with serum total cholesterol levels of 120-159 mg/dL, the corresponding adjusted hazard ratios of mortality were 4.20 (95% confidence interval [CI] = 1.01-17.4), 8.06 (95% CI = 2.02-32.2), and 6.89 (95% CI = 1.59-29.8) for those with cholesterol levels of <120 mg/dL, 160-199 mg/dL, and ≥200 mg/dL, respectively.


CONCLUSIONS
Dialysis patients with serum total cholesterol levels of ≥160 mg/dL or <120 mg/dL on admission are at an elevated hazard of 30-day mortality after ischemic stroke.
Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan; Department of Internal Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Division of Kidney Disease, China Medical University Hospital, Taichung, Taiwan.
I-Kuan
IK
Wang
Departmemt of Neurology, China Medical University Hospital, Taichung, Taiwan.
Chung-Hsiang
CH
Liu
Division of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan.
Tzung-Hai
TH
Yen
Neurology, National Taiwan University Hospital, Taipei, Taiwan.
Jiann-Shing
JS
Jeng
Department of Neurology, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan.
Shih-Pin
SP
Hsu
Department of Neurology, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Stroke Center, National Cheng Kung University Hospital, Tainan, Taiwan.
Chih-Hung
CH
Chen
Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital and Taipei Medical University College of Medicine, Taipei, Taiwan.
Li-Ming
LM
Lien
Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Ruey-Tay
RT
Lin
Department Neurology, Chung Shan Medical University Hospital, Taichung, Taiwan.
An-Chih
AC
Chen
Department of Neurology, Chi-Mei Medical Center, Tainan, Taiwan.
Huey-Juan
HJ
Lin
Show Chwan Memorial Hospital, Changhua. Taiwan.
Hsin-Yi
HY
Chi
Cheng Hsin General Hospital, Taipei, Taiwan.
Ta-Chang
TC
Lai
En Chu Kong Hospital, New Taipei City, Taiwan.
Yu
Y
Sun
Department of Neurology, Far Eastern Memorial Hospital, Taipei, Taiwan.
Siu-Pak
SP
Lee
Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan.
Sheng-Feng
SF
Sung
Taichung Veterans General Hospital, Taichung, Taiwan.
Po-Lin
PL
Chen
Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Jiunn-Tay
JT
Lee
Cathay General Hospital, Taipei, Taiwan.
Tsuey-Ru
TR
Chiang
Taipei Tzuchi Hospital, New Taipei City, Taiwan.
Shinn-Kuang
SK
Lin
Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
Chih-Hsin
CH
Muo
Monash University, Melbourne, Victoria, Australia.
Henry
H
Ma
Institute of Population Science, National Health Research Institute, Zhunan, Taiwan.
Chi-Pang
CP
Wen
Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan. Electronic address: fcsung1008@yahoo.com.
Fung-Chang
FC
Sung
Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan; Departmemt of Neurology, China Medical University Hospital, Taichung, Taiwan.
Chung Y
CY
Hsu
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D002784:Cholesterol / Q000097:blood*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D006435:Renal Dialysis / Q000009:adverse effects / Q000401:mortality; D012307:Risk Factors; D020521:Stroke / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors
D015415:Biomarkers; D002784:Cholesterol
Cholesterol; dialysis; ischemic stroke, mortality; prognosis