Dataset Information

Features of Serum Fatty Acids at Acute Ischemic Stroke Onset in Statin-Treated Patients with Hypercholesterolemia.

ABSTRACT: In addition to diet therapy, statins are used to prevent cardiovascular disease in patients with hypercholesterolemia (HC). However, acute ischemic stroke (AIS) still occurs in statin-treated patients. How strictly statin-treated patients follow diet therapy before they experience AIS and whether they increase seafood consumption remains unknown. We investigated the serum concentrations and proportions (weight percentages: wt %) of fatty acids (FAs) at AIS onset in statin-treated patients (statin group), compared to those in non-treated patients with HC (6.465 mmol/L or higher) as controls (non-treated group). We included patients with AIS admitted between 2016 and 2019 within 24 h of AIS onset who underwent analysis of serum FAs. During the study period, 188 patients met the inclusion criteria: 133 in the statin group and 55 in the non-treated group. Interestingly, serum FA concentrations in the statin group were lower than those in the non-treated group. However, serum FA wt % in the statin group was almost identical to that in the non-treated group. In conclusion, statin-treated AIS patients had low FA concentrations and identical FA wt %, compared to non-treated AIS patients with HC.

SUBMITTER: Mori T

PROVIDER: S-EPMC7551419 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Features of Serum Fatty Acids at Acute Ischemic Stroke Onset in Statin-Treated Patients with Hypercholesterolemia.

Mori Takahisa T Yoshioka Kazuhiro K Tanno Yuhei Y Kasakura Shigen S

Nutrients 20200916 9

In addition to diet therapy, statins are used to prevent cardiovascular disease in patients with hypercholesterolemia (HC). However, acute ischemic stroke (AIS) still occurs in statin-treated patients. How strictly statin-treated patients follow diet therapy before they experience AIS and whether they increase seafood consumption remains unknown. We investigated the serum concentrations and proportions (weight percentages: wt %) of fatty acids (FAs) at AIS onset in statin-treated patients (stati ...[more]

PMID: 32947895

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Project description:Background: Low lipid level is associated with better cardiovascular outcome. However, lipid paradox indicating low lipid level having worse outcomes could be seen under acute injury in some diseases. The present study was designed to clarify the prognostic significance of acute-phase lipid levels within 1 day after admission for stroke on mortality in first-ever statin-naïve acute ischemic stroke (IS) and hemorrhagic stroke (HS). Methods: This observational study was conducted using the data collected from Stroke Registry In Chang-Gung Healthcare System (SRICHS) between 2009 and 2012. Patients with recurrent stroke, onset of symptoms >1 day, and history of the use of lipid-lowering agents prior to index stroke were excluded. Stroke was classified into IS and hypertension-related HS. The primary outcomes were 30-day and 1-year mortality identified by linkage to national death registry for date and cause of death. Receiver operating characteristic (ROC) curve analysis and multivariate Cox proportional hazard models were used to examine the association of lipid profiles on admission with mortality. Results: Among the 18,268 admitted stroke patients, 3,746 IS and 465 HS patients were eligible for analysis. In IS, total cholesterol (TC) <163.5 mg/dL, triglyceride (TG) <94.5 mg/dL, low-density lipoprotein (LDL) <100 mg/dL, non-high-density lipoprotein cholesterol (non-HDL-C) <130.5 mg/dL, and TC/HDL ratio <4.06 had significantly higher risk for 30-day/1-year mortality with hazard ratio (HR) of 2.05/1.37, 1.65/1.31, 1.68/1.38, 1.80/1.41, and 1.58/1.38, respectively, compared with high TC, TG, LDL, non-HDL-C, and TC/HDL ratio (p < 0.01 in all cases). In HS, lipid profiles were not associated with mortality, except HDL for 30-day mortality (p = 0.025) and high uric acid (UA) concentrations for 30-day and 1-year mortality (p = 0.002 and 0.012, respectively). High fasting glucose and high National Institute of Health Stroke Scale (NIHSS) score at admission were associated with higher 30-day and 1-year mortality in both IS and HS and low blood pressure only in IS (p < 0.05). Synergic effects on mortality were found when low lipids were incorporated with high fasting glucose, low blood pressure, and high NIHSS score in IS (p < 0.05). Conclusions: Lipid paradox showing low acute-phase lipid levels with high mortality could be seen in statin-naïve acute IS but not in HS. The mortality in IS was increased when low lipids were incorporated with high fasting glucose, low blood pressure, and high NIHSS score.

Project description:IntroductionIt is well known that post-stroke depression (PSD) is a psychiatric complication after stroke which leads to worse functional outcome and poorer quality of life. Some risk factors including gender, stroke severity, lesion location, homocysteine (HCY), and so on are associated with PSD. This study aims to further explore the possible relationship between serum levels of HCY and early-onset PSD and the predictive value of HCY combined with stroke characteristics for early-onset PSD.MethodsTwo hundred forty-five patients with acute ischemic stroke who met the criteria were included in this study from March 2015 to March 2017. PSD was diagnosed at 2 weeks after stroke. The severity of depressive symptoms was evaluated with the Hamilton depression scale 17 items (HAMD-17), and patients with HAMD scores ≥7 were included in the PSD group. The demographic data, clinical characteristics, serum levels of HCY, and detailed radiological variables (e.g., lesion location and quantity of the brain infarct) were also examined.ResultsIn total, 97 (39.6%) patients of the 245 patients were diagnosed with depression. The univariate analyses suggested that patients in PSD group had a higher NIHSS score, modified Rankin Scale score, and HCY levels than patients in non-PSD group (p < .001). The patients with PSD had higher proportion of multiple-site acute infarcts and frontal lobe lesion (p < .05). In multivariate logistic regression analysis, NIHSS score at admission, serum levels of HCY, and multiple-site lesions were independently related to early-onset PSD. Based on receiver operating characteristic curves analysis, the combination of HCY, NIHSS scores, multiple-site lesions, and lesion location revealed a highest area under the curve of 0.807 (95% confidence interval [CI]: 0.748-0.865, p < .001). Furthermore, there was a significantly increased risk of early-onset PSD associated with serum levels of HCY ≥16.98 μmol/L (odds ratio [OR] = 10.976, 95% CI: 5.585-21.573, p < .001).ConclusionsOur study indicated that higher NIHSS score, elevated serum levels of HCY, and multiple-site lesions may be independent risk factors of early-onset PSD. The combination of HCY, NIHSS scores, multiple-site lesions, and lesion location may provide greater predictive value than HCY alone for early-onset PSD. Early intervention for elevated serum levels of HCY may be a potential target for the intervention and prevention of PSD.

Dataset Information

Features of Serum Fatty Acids at Acute Ischemic Stroke Onset in Statin-Treated Patients with Hypercholesterolemia.

Publications

Features of Serum Fatty Acids at Acute Ischemic Stroke Onset in Statin-Treated Patients with Hypercholesterolemia.

Similar Datasets

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