Higher Serum Triglyceride Level in Patients with Acute Ischemic Stroke Is Associated with Lower Infarct Volume on CT Brain Scans

Pikija, Slaven; Milevčić, Dražen; Trkulja, Vladimir; Kiđemet‐Piskač, Spomenka; Pavliček, Ivan; Сокол, Н. И.

doi:10.1159/000092780

Cited by 29 publications

(27 citation statements)

References 12 publications

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“…Although environmental and clinical risk factors (such as hypertension, diabetes mellitus, hyperlipemia, atherosclerosis, smoking, excessive alcohol drinking, and so on) are considered important [3,4], nowadays a growing spectrum of genetic susceptibility factors have been identified [5,6]. With the help of robust genome-wide association studies, the biological plausibility and epidemiological evidence suggest that the elevated triglyceride (TG) level potentially contributes to an increased risk for ischemic stroke [7,8,9]. …”

Section: Introductionmentioning

confidence: 99%

Apolipoprotein A5 Gene Promoter Region-1131T/C Polymorphism Is Associated with Risk of Ischemic Stroke and Elevated Triglyceride Levels: A Meta-Analysis

Zhang

Yang

et al. 2012

Cerebrovasc Dis

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Background: The association between polymorphism -1131T/C in the promoter region of apolipoprotein A5 (APOA5) and ischemic stroke and plasma triglyceride (TG) levels remains controversial. To better clarify the association between APOA5-1131T/C and risk of ischemic stroke and plasma TG levels, we performed a meta-analysis to examine the allele and genotype of APOA5-1131T/C polymorphism in ischemic stroke cases and controls. Methods: Based on the search of PubMed, Embase, MEDLINE, CNKI (National Knowledge Infrastructure) and CBM (Chinese BioMedical Literature Database) databases, we identified and abstracted outcome data from all articles to evaluate the association between APOA5 and ischemic stroke/plasma TG levels. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were performed in dominant model (CC + TC vs. TT), recessive model (CC vs. TC + TT), homozygote comparison (CC vs. TT) and heterozygote comparison (TC vs. TT). The association between dominant model (CC + TC vs. TT) and plasma TG/total cholesterol/high-density lipoprotein cholesterol levels was measured by a weighted mean difference (WMD) with its corresponding 95% CI. To evaluate the ethnicity-specific effects, subgroup analyses were performed by ethnic group. Results: A meta-analysis containing 2,294 ischemic stroke cases and 1,858 controls from 8 case-control studies was performed. The results showed that APOA5-1131T/C polymorphism was significantly associated with ischemic stroke in all comparison models (CC + TC vs. TT, OR = 1.70, 95% CI = 1.24–2.32; CC vs. TC + TT, OR = 1.36, 95% CI = 0.98–1.90; CC vs. TT, OR = 1.73, 95% CI = 1.34–2.23; TC vs. TT, OR = 1.67, 95% CI = 1.19–2.36). On subgroup analysis by ethnicity, similarly significant associations were found in both Asians and Europeans, and the Europeans possessed a higher risk of ischemic stroke, especially in CC versus TT model (OR = 4.47, 95% CI = 1.33–15.06). Significant association between the C allele and elevated TG levels was detected in both ischemic stroke cases and controls; the TG levels were higher in the ischemic stroke cases and controls carrying the APOA5-1131C allele than in the noncarriers (CC + TC vs. TT, cases WMD = 0.43, 95% CI = 0.27–0.59; controls WMD = 0.51, 95% CI = 0.35–0.66). Similar within-group comparison of the total cholesterol and high-density lipoprotein cholesterol levels did not show any difference. Conclusions: Our meta-analysis revealed that the APOA5-1131T/C polymorphism is associated with a significant risk of ischemic stroke and elevated TG levels. The CC genotype and C allele might be a genetic risk factor that increases susceptibility of ischemic stroke and elevates plasma TG levels, and might be a useful target for clinical therapeutic intervention.

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Section: Introductionmentioning

confidence: 99%

Apolipoprotein A5 Gene Promoter Region-1131T/C Polymorphism Is Associated with Risk of Ischemic Stroke and Elevated Triglyceride Levels: A Meta-Analysis

Zhang

Yang

et al. 2012

Cerebrovasc Dis

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“…While several observational studies have not found any consistent association between prestroke total cholesterol (TC) levels and stroke mortality, [18] post-stroke levels of TC seem to have a negative association with stroke mortality and prognosis [8,24]. Moreover, low serum triglyceride (TG) levels have been associated with increased mortality after an ischemic stroke (IS) [25].…”

Section: Introductionmentioning

confidence: 99%

Sex differences in the prognostic value of the lipid profile after the first ischemic stroke

et al. 2009

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Post-stroke levels of total cholesterol (TC) appear to be negatively associated with stroke mortality. Statin pretreatment might affect this association. Sex differences in the prognostic value of the lipid profile have not yet been studied. We have evaluated the impact of TC, high- and low-density lipoprotein (HDL and LDL, respectively), and triglyceride (TG) levels on the 3-month outcome after a first ischemic stroke (IS) according to sex and previous statin use. The study group consisted of a hospital-based cohort of consecutive patients with a diagnosis of first IS. Poor outcome was defined as a modified Rankin Scale (mRS) score >or=3 at 90 days. The odds ration (OR) for poor prognosis was analyzed for each sex using logistic regression models adjusted for vascular risk factors and statin pretreatment. A total of 591 patients were included in the analysis (318 men). The predictors of a 90-day poor outcome were age and initial NIH Stroke Scale (NIHSS) score in women, and age, initial NIHSS, smoking, atrial fibrillation, and thrombolytic treatment in men. In women, none of the lipids studied affected the 90-day prognosis. Men falling in the last quintile of TC [OR: 0.68 95% confidence interval (95% CI) 0.52-0.88; p = 0.004] and LDL (OR 0.74, 95% CI 0.56-0.98; p = 0.04) have better outcome than men in the first quintile. Adjusting for statin pretreatment did not change the results. The results indicated that an association between poststroke lipids and prognosis may vary by sex. In women, lipids were not associated with the outcome; in men, lower TC and LDL were associated with worse prognosis. These differences can not be explained by statin use and require further research.

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“…Previous studies have shown patients with serum triglyceride levels below 150 mg/dL on admission after acute stroke are associated with stroke severity and worse prognosis [6][7][8][9][10][11][12][13]17]. A retrospectively study found a higher serum triglyceride level (≥ 150 mg/dL) within 24 h after admission is associated with a lower infarct volume on CT brain scans [6]. Dziedzic et al [7] have shown that a higher level of serum triglyceride (>2.3 mmol/L) is associated with 42% reduced stroke severity [7].…”

Section: Discussionmentioning

confidence: 99%

“…However, studies also found that low serum triglyceride levels measured in the early period after stroke are predictive of higher infarct volume [6], more severity [7,8], and both elevated short-term mortality and long-term mortality [9][10][11][12][13]. On the other hand, a Korean study found a J-shape relation between triglyceride levels and early neurological deterioration and mortality [14].…”

Section: Introductionmentioning

confidence: 99%

Lower Fasting Serum Triglyceride Levels on Admission are Associated with Increased Risks of 30-Day and 1-Year Mortality in Patients with Ischemic Stroke

Wang¹,

Liu²,

Yen³

et al. 2018

Angiol

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Objective:This study was to assess the 30-day and 1-year mortality associated with serum triglyceride levels on admission for patients with acute ischemic stroke using the Taiwan Stroke registry (TSR) data. Patients and methods:From the TSR database, we identified 45931 acute ischemic stroke patients from April 2006 to April 2014 and stratified them into 3 groups by the serum triglyceride level measured on admission: <150 mg/dL, 150 mg/dL -199 mg/dL, and ≥ 200 mg/dL. They were prospectively followed to measure the 30-day and 1-year mortality after acute ischemic stroke. Result:The mortality rate after acute ischemic stroke decreased as the triglyceride level increased. The 30-day mortality rate was 2.3-fold greater in patients with triglyceride levels <150 mg/dL than patients with triglyceride levels >200 mg/dL (1.62 vs.0.72 per 1000 person-days), with an adjusted hazard ratio (HR) of 1.25 (95% confidence interval (CI)=1.06-1.46). The 1-year mortality rate was also greater in patients with lower triglyceride levels than in patients with higher levels (0.47 vs. 0.22 per 1000 person-days), with an adjusted HR of 1.21 (95% CI=1.09-1.34). Compared to patients with triglyceride levels >200 mg/dL, those with triglyceride levels <150 mg/dL had 2.2% lower 30-day survival rate and 6.3% lower 1-year survival rate after acute ischemic stroke. Conclusion:Acute ischemic stroke patients with lower fasting serum triglyceride levels on admission are at a higher risk of both 30-day mortality and 1-year mortality.

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Higher Serum Triglyceride Level in Patients with Acute Ischemic Stroke Is Associated with Lower Infarct Volume on CT Brain Scans

Cited by 29 publications

References 12 publications

Apolipoprotein A5 Gene Promoter Region<b><i>-1131T/C</i></b> Polymorphism Is Associated with Risk of Ischemic Stroke and Elevated Triglyceride Levels: A Meta-Analysis

Apolipoprotein A5 Gene Promoter Region<b><i>-1131T/C</i></b> Polymorphism Is Associated with Risk of Ischemic Stroke and Elevated Triglyceride Levels: A Meta-Analysis

Sex differences in the prognostic value of the lipid profile after the first ischemic stroke

Lower Fasting Serum Triglyceride Levels on Admission are Associated with Increased Risks of 30-Day and 1-Year Mortality in Patients with Ischemic Stroke

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