Neurology: Effects of hypertriglyceridemia on prognosis in patients with atherosclerotic stroke

Atherosclerotic stenosis of the large cervical arteries is a common cause of ischemic stroke
.

Patients with atherothrombotic stroke had the highest risk of further vascular events compared with patients with other stroke subtypes, with an annual risk of more than 15% in high-risk patients

Atherosclerotic stenosis of the large cervical arteries is a common cause of ischemic stroke

The primary goal of lipid management in secondary stroke prevention is to lower ldl-c levels with statins

The relationship between hypertriglyceridemia and atherothrombotic stroke has been poorly studied, and its prognostic role is unclear

The Tokyo Women's Medical University Stroke Registry is an ongoing prospective, observational registry in which 870 patients with acute ischemic stroke or transient ischemic attack were registered within one week of onset and followed for one year
.

Hypertriglyceridemia was defined as fasting serum triglycerides ≥ 150 mg/dl

The Tokyo Women's Medical University Stroke Registry is an ongoing prospective, observational registry in which 870 patients with acute ischemic stroke or transient ischemic attack were registered within one week of onset and followed for one year

• Hypertriglyceridemia was present in 217 (24.
  9%) of 870 patients (mean age 70.
  1 years, 60.
  9% male)
  .
  
• High triglyceride levels were significantly associated with increased incidence of intracranial arterial stenosis, especially in the anterior circulation, but not extracranial arterial stenosis
  .
  
• Even after adjusting for potential confounders, including baseline LDL cholesterol and statin use (adjusted hazard ratio, 2.
  46; 95% confidence interval, 1.
  62-3.
  74), patients with hypertriglyceridemia developed severe The risk of adverse cardiovascular events was also higher than in patients who did not experience such events (annual rate, 20.
  9% vs.
  9.
  7%; p < 0.
  001)
  .
  
• Patients with hypertriglyceridemia had a higher risk of vascular events than patients without hypertriglyceridemia (n = 174, annual rate 35.
  1% vs 14.
  2%, p = 0.
  001), and patients with significant intracranial arterial stenosis (n = 174, annual rate 35.
  1% vs.
  = 247, annual incidence 29.
  9% vs 14.
  7%, p = 0.
  006), and stenosis in those with marked extracranial artery stenosis (n = 123, annual incidence 23.
  0%, 9.
  4%, p = 0.
  042)
  .
  
• In contrast, hypertriglyceridemia did not predict recurrent vascular events in patients with cardioembolic stroke (n = 221; annual incidence 19.
  1% vs 10.
  5%; p = 0.
  18)
  .
  

Hypertriglyceridemia was present in 217 (24.
9%) of 870 patients (mean age 70.
1 years, 60.
9% male)
.

Hypertriglyceridemia was present in 217 (24.
9%) of 870 patients (mean age 70.
1 years, 60.
9% male)
.

High triglyceride levels were significantly associated with increased incidence of intracranial arterial stenosis, especially in the anterior circulation, but not extracranial arterial stenosis

Hypertriglyceridemia is an important modifiable risk factor contributing to residual vascular risk in patients with atherothrombotic stroke, even during statin therapy

Trial registration information: The registration at the Tokyo Women's Medical University Stroke Registry https://upload.

This study provides first-level evidence that in patients with atherothrombotic stroke, hypertriglyceridemia is associated with an increased risk of major cardiovascular events

Source: Hoshino T, Ishizuka K, Toi S, et al.
Prognostic Role of Hypertriglyceridemia in Patients With Stroke of Atherothromotic Origin [published online ahead of print, 2022 Mar 16].
Neurology.
2022;10.
1212/WNL.
0000000000200112.
doi: 10.
1212/WNL.
0000000000200112 Hoshino T, Ishizuka K, Toi S, et al.
Prognostic Role of Hypertriglyceridemia in Patients With Stroke of Atherothromotic Origin [published online ahead of print, 2022 Mar116].
Neurology.
2022;10.
1212/WNL.
000000000200 doi:10.
1212/WNL.
0000000000200112Leave a message here