Ischemic Stroke and its Correlation with Low Blood Cholesterol Levels: Ischemic Stroke and Low Cholesterol Levels

Saima Rafique; Muhammad Aslam Rind Baloch; Maria Nazir; Muhammad Saleem

doi:10.54393/pjhs.v4i12.1201

Authors

Saima Rafique Department of Medicine, Bhitai Medical and Dental College, Mirpur Khas, Pakistan
Muhammad Aslam Rind Baloch Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
Maria Nazir Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
Muhammad Saleem Department of Medicine, People's University of Medical and Health Sciences, Nawabshah, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v4i12.1201

Keywords:

Ischemic Stroke, Cholesterol Levels, Lipoproteins

Abstract

Ischemic stroke occurs as a result of blockage of blood supply to the brain. It causes damage of brain tissue due to less availability of oxygen and nutrients. HDL-C is a significant risk factor for ischemic stroke. Objective: To evaluate the low HDL-C levels in ischemic stroke hospitalized patients. Methods: It is a descriptive cross sectional retrospective study conducted at Liaquat University Hospital, Hyderabad, Pakistan. The anticipated association of abnormal HDL-C levels in ischemic stroke was assessed in 200 cases. The data were collected from hospital records, patients were confirmed for stroke on the basis of CT scan. This descriptive analysis was performed based on the lab findings of patients from hospital records. Medical history, CT scans and demographic information of patients was obtained from hospital records after taking data collection permission from hospital. Results: A low level of HDL-C was identified in 126 patients (64%) according to the study's results. When the HDL-C values of ischemic stroke patients were compared using the Chi-Square Test, the p value obtained was 0.0001. Conclusions: The majority of ischemic stroke patients had low serum HDL-C levels. This study suggests an association of low serum HDL-C levels with susceptibility or risk for ischemic stroke.

References

Mathers CD, Boerma T, Ma Fat D. Global and regional causes of death. British Medical Bulletin. 2009 Dec; 92(1): 7–32. doi:10.1093/bmb/ldp028. DOI: https://doi.org/10.1093/bmb/ldp028

Saxena T. Cell death in stroke: Role of metabolism. Austin Journal of Cerebrovascular Disease and Stroke. 2017 May; 4(2): 1059. doi:10.26420/austinjcerebrovascdisstroke.2017.1059. DOI: https://doi.org/10.26420/austinjcerebrovascdisstroke.2017.1059

Brewer HB. Increasing HDL cholesterol levels. New England Journal of Medicine. 2004 Apr; 350(15): 1491–4. doi:10.1056/nejmp048023. DOI: https://doi.org/10.1056/NEJMp048023

Harbison J, Massey A, Barnett L, Hodge D, Ford GA. Rapid ambulance protocol for acute stroke. The Lancet. 1999 Jun; 353(9168): 1935. doi:10.1016/s0140-6736(99)00966-6. DOI: https://doi.org/10.1016/S0140-6736(99)00966-6

Bhalla M. Challenges to utility of abbreviated MRI Brain Protocol designed for acute stroke. American Society of Neuroradiology (ASNR) 58th Annual Meeting 2020: ePosters. 2020 Jun; doi:10.26226/morressier.5e5e70e135f8e2df5e55a2b3. DOI: https://doi.org/10.26226/morressier.5e5e70e135f8e2df5e55a2b3

Studnek JR, Asimos A, Dodds J, Swanson D. Assessing the validity of the Cincinnati prehospital stroke scale and the medic Prehospital Assessment for Code Stroke in an Urban Emergency Medical Services Agency. Prehospital Emergency Care. 2013 Jul; 17(3): 348–53. doi:10.3109/10903127.2013.773113. DOI: https://doi.org/10.3109/10903127.2013.773113

De Luca A, Mariani M, Riccardi MT, Damiani G. The role of the Cincinnati Prehospital Stroke Scale in the emergency department: evidence from a systematic review and meta-analysis. Open Access Emergency Medicine. 2019 Jul; 147-59. 10.2147/OAEM.S178544. DOI: https://doi.org/10.2147/OAEM.S178544

Brown BG, Zhao XQ, Chait A, Fisher LD, Cheung MC, Morse JS, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. New England Journal of Medicine. 2001 Nov; 345(22): 1583-92. doi:10.1016/s1062-1458(02)00657-8. DOI: https://doi.org/10.1056/NEJMoa011090

Khan MN, Khan HD, Ahmad M, Umar M. Serum total and HDL-cholesterol in ischemic and hemorrhagic stroke. Annals of Pakistan Institute of Medical Sciences. 2014 Jan; 10(1): 22-6.

University of Rochester Medical Center. Health Encyclopedia. [Last cited: 19th Jan 2024]. Available at: https://www.urmc.rochester.edu/encyclopedia.aspx.

Mansur A de and Favarato D. Mortality due to cardiovascular diseases in women and men in the five Brazilian regions, 1980-2012. Arquivos Brasileiros de Cardiologia. 2016 Jul; 107: 137-46. doi:10.5935/abc.20160102. DOI: https://doi.org/10.5935/abc.20160102

Tkucahev N. Solar alpha particles and death from ischemic heart disease. Research Review. 2023 Jun; 06(06): 1616-25. doi:10.52845/cmro/2023/6-6-2. DOI: https://doi.org/10.52845/CMRO/2023/6-6-2

Lotufo PA. Stroke is still a neglected disease in Brazil. Sao Paulo Medical Journal. 2015 Nov; 133(6): 457–9. doi:10.1590/1516-3180.2015.13360510. DOI: https://doi.org/10.1590/1516-3180.2015.13360510

Schindel D, Schneider A, Grittner U, Jöbges M, Schenk L. Quality of life after stroke rehabilitation discharge: a 12-month longitudinal study. Disability and Rehabilitation. 2021 Jul 31; 43(16): 2332-41. doi:10.1080/09638288.2019.1699173. DOI: https://doi.org/10.1080/09638288.2019.1699173

Zhang XX, Wei M, Shang LX, Lu YM, Zhang L, Li YD, et al. LDL-C/HDL-C is associated with ischaemic stroke in patients with non-valvular atrial fibrillation: a case-control study. Lipids in Health and Disease. 2020 Dec; 19(1): 1-1. doi:10.21203/rs.3.rs-60899/v1. DOI: https://doi.org/10.1186/s12944-020-01392-7

Wang G, Jing J, Wang A, Zhang X, Zhao X, Li Z, et al. Non–high-density lipoprotein cholesterol predicts adverse outcomes in acute ischemic stroke. Stroke. 2021 Jun; 52(6): 2035–42. doi:10.1161/strokeaha.120.030783. DOI: https://doi.org/10.1161/STROKEAHA.120.030783

Wang Y, Song Q, Cheng Y, Wei C, Ye C, Liu J, et al. Association between non-high-density lipoprotein cholesterol and haemorrhagic transformation in patients with acute ischaemic stroke. BMC Neurology. 2020 Dec; 20(1): 1-9. doi:10.1186/s12883-020-1615-9. DOI: https://doi.org/10.1186/s12883-020-1615-9

Yuan S, Huang X, Ma W, Yang R, Xu F, Han D, et al. Associations of HDL-C/LDL-C with myocardial infarction, all-cause mortality, haemorrhagic stroke and Ischaemic Stroke: A Longitudinal Study based on 384 093 participants from the UK Biobank. Stroke and Vascular Neurology. 2023 Apr; 8(2). doi:10.1136/svn-2022-001668. DOI: https://doi.org/10.1136/svn-2022-001668

Zhou P, Liu J, Wang L, Feng W, Cao Z, Wang P, et al. Association of small dense low-density lipoprotein cholesterol with stroke risk, severity and prognosis. Journal of Atherosclerosis and Thrombosis. 2020 Dec; 27(12): 1310–24. doi:10.5551/jat.53132. DOI: https://doi.org/10.5551/jat.53132

Ramírez-Moreno JM, Rebollo B, Macías-Sedas P, Valverde N, Parejo A, Felix-Redondo FJ, et al. Strength of association of classical vascular risk factors in young patients with Ischaemic Stroke: A case-control study. Neurología (English Edition). 2022 Oct; doi:10.1016/j.nrleng.2022.07.006. DOI: https://doi.org/10.1016/j.nrleng.2022.07.006

Hwang J, Lee Y, Kang K, Eun MY. Acute ischemic stroke caused by intracranial atherosclerosis associated with lorlatinib-induced dyslipidemia. Journal of Clinical Neurology. 2023 Jan; 19(1): 90. doi:10.3988/jcn.2023.19.1.90. DOI: https://doi.org/10.3988/jcn.2023.19.1.90

Martinez-Majander N, Gordin D, Joutsi-Korhonen L, Salopuro T, Adeshara K, Sibolt G, et al. Markers of early vascular aging are not associated with cryptogenic ischemic stroke in the young: A case-control study. Journal of Stroke and Cerebrovascular Diseases. 2022 Sep; 31(9): 106647. doi:10.1016/j.jstrokecerebrovasdis.2022.106647. DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106647

Duan R, Xue W, Wang K, Yin N, Hao H, Chu H, et al. Estimation of the LDL subclasses in ischemic stroke as a risk factor in a Chinese population. BMC Neurology. 2020 Dec; 20(1). 1-9. doi:10.1186/s12883-020-01989-6. DOI: https://doi.org/10.1186/s12883-020-01989-6

Hossain A, Zahir KM, Haque MO and ul Azim MA. Study of ischemic stroke at young age (<25 years) of 50 patients admitted at SBMCH, Barisal. Journal of Medical Science And Clinical Research. 2020 Dec; 08(12): 90-95. doi:10.18535/jmscr/v8i12.15. DOI: https://doi.org/10.18535/jmscr/v8i12.15

Jaffar M, Rafique A, Khalid S, Waheed S. Frequency of dyslipidemia in ischemic stroke patients presented to Tertiary Care Hospital of Lahore. Pakistan Journal of Medical and Health Sciences. 2021 Oct; 15(10): 3417–9. doi:10.53350/pjmhs2115103417. DOI: https://doi.org/10.53350/pjmhs2115103417

Alkhaneen H, Alsadoun D, Almojel L, Alotaibi A, Akkam A. Differences of lipid profile among ischemic and hemorrhagic stroke patients in a tertiary hospital in Riyadh, Saudi Arabia: A retrospective cohort study. Cureus. 2022 May; 14(5). doi:10.7759/cureus.25540. DOI: https://doi.org/10.7759/cureus.25540