Abstract 492: Atherogenic Dyslipidemia in Patients with Transient Ischemic Attack

Abstract

Background: The risk of recurrent stroke following transient ischemic attack (TIA) is reported up to 15% at 90 days after the attack. Urgent assessment and combined use of preventive treatments in appropriate patients can reduce this risk significantly. The atherogenic dyslipidemia in patients with TIA may be associated with intracranial artery stenosis and higher risk of early recurrent stroke. This study was aimed to investigate if dyslipidemia was related to atherosclerotic vascular lesions in the TIA patients. Methods: Patients with TIA who admitted to single hospital were included. TIA was defined as an acute loss of focal cerebral function, lasting fewer than 24 hours. If brain magnetic resonance imaging scans showed acute infarction, the patient was judged to have a TIA with a new lesion; if not, the event was classified as TIA without a new lesion. Radiologic findings were reviewed retrospectively. Association between presence of atherosclerotic vascular lesions and lipid profile were examined. Atherogenic dyslipidemia was defined as high density lipoprotein (HDL) cholesterol ≤ 40 mg/dL and triglycerides ≥ 150 mg/dL. Level of non-HDL cholesterol was calculated as total cholesterol concentration minus HDL cholesterol concentration. Presence of classic risk factors of atherosclerosis and vascular disease were also reviewed. Results: Among 117 TIA patients, 106 patients who had available results were included to the analysis. Mean age was 64 years (± 13), and 48 were men (42.1%). Atherosclerotic vascular lesion was shown in 56 patients (52.8%). Presence of atherosclerotic vascular lesions was associated with age, diabetes, low density lipoprotein (LDL) cholesterol concentrations, and level of CRP. Atherogenic dyslipidemia was not related to vascular lesions. Among 106 patients, only 18 patients (17.0%) were diagnosed as TIA with a new lesion. Presence of acute cerebral infarction was associated with presence of atherosclerosis. Diabetes and current smoking were associated with new ischemic lesion related TIA. Conclusions: In TIA patients, concentrations of LDL cholesterol were related atherosclerotic vascular lesion which is known to be associated with recurrent stroke after TIA. It might be helpful to screen high risk TIA patient.