Lipid Levels and Short-Term Risk of Recurrent Brain Infarcts in Symptomatic Intracranial Stenosis
| Autor: | Shyam Prabhakaran, Rajbeer S Sangha, Edward Feldmann, Iszet Campo-Bustillo, David S Liebeskind, George Cotsonis, Azhar Nizam, Jose G. Romano, MyRIAD Investigators |
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| Rok vydání: | 2021 |
| Předmět: |
Brain Infarction
Male medicine.medical_specialty Statin medicine.drug_class Gastroenterology Article chemistry.chemical_compound Predictive Value of Tests Recurrence Risk Factors Internal medicine Hyperlipidemia medicine Humans Risk factor Stroke Triglycerides Subclinical infection Aged medicine.diagnostic_test business.industry Cholesterol Rehabilitation Cholesterol HDL Magnetic resonance imaging Cholesterol LDL Middle Aged medicine.disease Intracranial Arteriosclerosis Lipids medicine.anatomical_structure chemistry Surgery Female Neurology (clinical) Cardiology and Cardiovascular Medicine business Biomarkers Artery |
| Zdroj: | J Stroke Cerebrovasc Dis |
| ISSN: | 1532-8511 |
| Popis: | Objectives Hyperlipidemia is a strong risk factor for intracranial atherosclerotic disease (ICAD) and clinical stroke recurrence. We explored the effect of serum lipid levels on subclinical infarct recurrence in the Mechanisms of earlY Recurrence in Intracranial Atherosclerotic Disease (MYRIAD) study. Materials and Methods We included enrolled MYRIAD patients with lipid measurements and brain MRI at baseline and brain MRI at 6-8 weeks. Infarct recurrence was defined as new infarcts in the territory of the symptomatic artery on brain MRI at 6-8 weeks compared to baseline brain MRI. We assessed the association between baseline total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) levels and recurrent infarct at 6-8 weeks using multivariable logistic regression. Results Among 74 patients (mean age 64.2±12.9 years, 59.5% were white, 60.8% men), 20 (27.0%) had new or recurrent infarcts. Mean HDL-C (37.2 vs. 43.9 mg/dL, P=0.037) was lower and TG (113.5 vs. 91.3 mg/dL, P=0.008) was higher while TC (199.8 vs. 174.3 mg/dL, P=0.061) and LDL-C (124.3 vs. 101.2 mg/dL, P=0.053) were nominally higher among those with recurrent infarcts than those without. LDL-C (adj. OR 1.022, 95% CI 1.004-1.040, P=0.015) and TG (adj. OR 1.009, 95% CI 1.001-1.016, P=0.021) were predictors of recurrent infarct at 6-8 weeks adjusting for other clinical and imaging factors. Conclusions Baseline cholesterol markers can predict early infarct recurrence in patients with symptomatic ICAD. More intensive and rapid lipid lowering drugs may be required to reduce risk of early recurrence. |
| Databáze: | OpenAIRE |
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