Abstract WP194: Ldlc Levels, Lipid Lowering Treatment And Recurrent Stroke In Minor Ischemic Stroke Or Tia

To investigate the association between baseline low-density lipoprotein cholesterol (LDL-C) level, lipid lowering treatment and short-term risk of new stroke in patients with a minor ischemic stroke or transient ischemic attack (TIA). We derived data from the Clopidogrel in High-risk patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial. Patients with a minor stroke or TIA were categorized by LDL-C level at baseline (<100 or ≥100 mg/dL [2.6 mmol/L]) and with or without lipid lowering treatment after symptom onset. The primary outcome was a new ischemic stroke at 3 months. The association of baseline LDL-C level and effect of lowering treatment were assessed. Among 3,027 patients, 2,154(71.2%) patients had an initial LDL-C ≥100 mg/dL, of which 1,267(41.9%) received lipid lowering treatment. Elevated LDL-C level was associated with a higher risk of new ischemic stroke at 3 months in patients without lipid lowering treatment (adj.HR=1.35, 95%CI: 1.19-1.53), but not in those with lipid lowering treatment (adj.HR=0.99, 95%CI: 0.82-1.19) (p for interaction=0.007). Patients with LDL-C ≥100 mg/dL had a trend towards higher risk of ischemic stroke (11.8% vs. 8.0%, adj.HR=1.37, 95%CI: 0.96-1.96) in those without lipid lowering treatment. For patients with LDL-C ≥100 mg/dL, lipid lowering treatment was associated with reduced risk of ischemic stroke at 3 months (7.9% vs. 11.8%; adj.HR=0.54, 95%CI: 0.39-0.75). Elevated untreated baseline LDL-C level was associated with an increased short-term risk of ischemic stroke among patients presenting with minor ischemic stroke or TIA. There was potential benefit of lipid lowering treatment in stroke patients.

Duke Scholars

Author Ying Xian Neurology, Neurocritical Care