Abstract Number ‐ 262: Cognitive Decline in Patients with Symptomatic Intracranial Stenosis and Effect of Serum Lipid Profile

Abstract

Introduction We determined the effect of baseline low density lipoprotein (LDL) and triglyceride (TG) concentrations on cognitive decline, in patients with symptomatic high grade intracranial stenosis. Methods We analyzed a cohort of stroke patients who had baseline and 4 months follow‐up Montreal Cognitive Assessment (MoCA) scores. MoCA score worsening after 4 months was the outcome of interest, defined as worsening of ≥ 2 points from baseline. Baseline LDL and TG concentrations (mg/dl) were assessed, and univariate and multivariate analysis using logistic regression were performed to identify predictors of worsening MoCA scores. Results A total of 349 patients were analyzed. 313 and 315 patients had baseline LDL and TG, respectively. 61 (17%) had a worsening of MoCA scores. The mean baseline LDL was 97.3 (39.1) in the worsening group, compared to 110.6 (44.8) in those with no worsening (p = 0.014). 23% of patients with LDL < 100 had worsening in MoCA score compared to 11% of patients with LDL ≥ 100 (p< 0.006). The mean baseline TG was 145.7 (102.2) in the worsening group, compared to 170.7 (135.4) (p = 0.053). On multivariate analysis, higher age (p = 0.014) and lower baseline LDL (p = 0.046) were predictors of worsening MoCA scores. Conclusions Patients who did not undergo any worsening MoCA scores had higher LDL and TG levels at baseline, and only older age and lower baseline LDL scores predicted worsening scores at 4 months. Presumably, the patients with high baseline lipid levels were treated more aggressively with dietary modifications and statins, which could have led to cognitive protective effect regardless of serum lipid profile.