Serum Cholesterol and Risk of Ischemic Stroke: Results of a Case-Control Study

Mascio, Rocco Di; Marchioli, Roberto; Vitullo, F; A, Pasquale; Cavasinni, L; Tognoni, Gianni

doi:10.1006/pmed.1995.1025

Cited by 21 publications

(14 citation statements)

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“…Stroke, however, is a very heterogeneous syndrome which includes different pathophysiogenetic subtypes, and there are several lines of evidence indicating a positive association of serum total cholesterol with cortical artery infarction and an inverse association with cerebral hemorrhage [52, 53, 54, 55, 56, 57]. The large majority of the clinical studies included in this overview, however, grouped all stroke subtypes together, and it is well known that fatal strokes are more likely to be hemorrhagic than ischemic.…”

Section: Discussionmentioning

confidence: 99%

Cholesterol Reduction and Stroke Occurrence: An Overview of Randomized Clinical Trials

Mascio¹,

Marchioli²,

Tognoni³

2000

Cerebrovasc Dis

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We performed a meta-analysis of randomized clinical trials of more than 6 months duration to describe how fatal and nonfatal strokes are related to cholesterol lowering and to the type of intervention. A total of 41 individual trials including approximately 80,000 subjects and followed for an average of about 4 years were included in the overview. There was a 16% (95% CI, 7–25%) reduction in risk of stroke among treated patients compared to control patients (test for heterogeneity, p = 0.76). When trials that used different interventions were separately examined, a significant reduction in stroke occurrence was observed only for those using statins as active treatment (risk reduction 23%; 95% CI 13–33%). A variance-weighted regression analysis of the logarithmic odds ratios for stroke incidence against the percentage of cholesterol reduction indicated that a reduction of fatal and nonfatal stroke can be obtained for a cholesterol reduction of 9% (95% CI 6.8–13.6%). The combined data of primary and secondary prevention trials indicate that a large reduction of blood cholesterol, achievable with statin drugs, can reduce the incidence of stroke.

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Section: Discussionmentioning

confidence: 99%

Cholesterol Reduction and Stroke Occurrence: An Overview of Randomized Clinical Trials

Mascio¹,

Marchioli²,

Tognoni³

2000

Cerebrovasc Dis

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“…Three decades of research of this topic have yielded inconsistent results [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] and have led to sharply opposing viewpoints about the importance of circulating cholesterol in ischemic stroke. 10,20 -24 At least part of the controversy can be attributed to methodological shortcomings of previous work.…”

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confidence: 99%

Plasma Lipid Profile and Incident Ischemic Stroke

Shahar

Chambless

Rosamond

et al. 2003

Stroke

278

122

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Background and Purpose-The role of circulating lipids and lipoproteins in the pathogenesis of ischemic stroke remains uncertain despite 3 decades of research. We examined this issue in a large population-based cohort. Methods-Between 1987 and 1989, 14 175 middle-aged men and women, free of clinical cardiovascular disease, took part in the first examination of the Atherosclerosis Risk in Communities (ARIC) study cohort. Baseline measurements included plasma levels of LDL cholesterol, HDL cholesterol, apolipoprotein B, apolipoprotein A-1, and triglycerides and myriad risk factors for cardiovascular disease. The cohort was followed for cardiovascular disease end points. Results-Over an average follow-up of 10 years (142 704 person-years at risk), we documented clinical ischemic stroke in 305 participants (161 men and 144 women). After multivariable adjustment for stroke risk factors, categorical and spline regression analyses of the entire sample, as well as the sample of men alone, revealed weak and inconsistent associations between ischemic stroke and each of the 5 lipid factors. Among women, the most consistent findings were decreasing risk of ischemic stroke within the top half of the distribution of HDL cholesterol and increasing risk within the lower range of the triglyceride distribution. Conclusions-The relation of circulating cholesterol to ischemic stroke does not resemble its well-known relation to coronary heart disease. Either the pathogenesis of a substantial proportion of ischemic strokes does not involve classic atherosclerotic mechanisms, or the effect of plasma lipids on atherogenesis is substantially different in the intracranial vascular bed.

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“…13, 14 Iso et al found an inverse relation between cholesterol level and haemorrhagic stroke but a positive association with non haemorrhagic stroke. 15 There was no correlation between serum cholesterol and risk of stroke in a study by Harmsen et al Rastenyte et al and Hart CL et al [16][17][18] found that serum cholesterol levels are not related to risk of death from stroke.…”

Section: Discussionmentioning

confidence: 96%

Study of lipid profile in cases of non-diabetic stroke

et al. 2018

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Background: To study serum lipid profile in non-diabetic patients with stroke and to determine whether there is any significant correlation between them and to compare the serum lipid profile between ischaemic and haemorrhagic group. Design: Case control study.Methods: The current study was done in the Department of Medicine VIMSAR, Burla, Odisha. Total 100 patients of completed stroke (Ischaemic63 and haemorrhagic37) and 30 controls were included in the study. All cases were adult (more than 14 years of age). Patients with suspected embolic stroke, diabetes (Type 1 and 2) and patients on lipid lowering drugs were excluded from the study. Routine investigations and fasting serum lipid profile was done.Results: 45 patients had elevated serum total cholesterol levels out of which 75.56% had Ischaemic stroke and 24.49% had haemorrhagic stroke. 24 cases had elevated serum Triglyceride levels of which 66.67% had Ischaemic stroke and 29.17% had haemorrhagic stroke. 76.47% of cases having elevated serum LDL cholesterol suffered from Ischaemic stroke where as 20.59% had haemorrhagic stroke.Conclusions: A statistically positive correlation was found between serum total cholesterol, Triglyceride, LDL levels and the risk of stroke.

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Serum Cholesterol and Risk of Ischemic Stroke: Results of a Case-Control Study

Cited by 21 publications

References 0 publications

Cholesterol Reduction and Stroke Occurrence: An Overview of Randomized Clinical Trials

Cholesterol Reduction and Stroke Occurrence: An Overview of Randomized Clinical Trials

Plasma Lipid Profile and Incident Ischemic Stroke

Study of lipid profile in cases of non-diabetic stroke

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