Abstract TP250: Poor Control of Hyperlipidemia Prior to Ischemic Stroke

Abstract

Introduction: Hyperlipidemia is a key modifiable risk factor for ischemic stroke. Data suggest a strong correlation between low-density lipoprotein cholesterol (LDL) levels and the incidence of cardiovascular events. Few studies have addressed the scope of LDL undertreatment prior to ischemic stroke. Methods: A retrospective analysis was conducted on patients with ischemic stroke to study patterns of hyperlipidemia undertreatment using LDL levels as a marker. A total of 826 patients admitted from 2018-2020 were stratified into three LDL categories: 1) High (130-159), 2) Very High (160-189), and 3) Extremely High (190 or higher). A chi-squared analysis was performed to determine if there was a significant difference in proportion based on sex, race, age, diabetes (DM) status, history of heart disease and statin use among patients across the three LDL categories. An ANOVA analysis was also performed to determine if a significant difference exists between the mean ages of the three LDL categories. Results: Of the 826 patients, there were 178 patients (21.5%) whose LDL-C values were greater than 130. 106 (12.8%) were classified as High, 50 (6.0%) as Very High, and 22 (2.7%) as Extremely High. For the High group, 61 (57.5%) were male, 29 (27.4%) had DM, 32 (30%) were older than 70, and 89 (84%) had a history of heart disease. For the Very High group, 16 (32%) had DM and 40 (80%) had a history of heart disease. For the Extremely High group, 32% had DM and 36% had heart disease. There was no significant correlation between the three LDL categories and the various patient characteristics. Conclusion: A broad group of patients (including those of different sexes, races, and ages) presented with markedly elevated LDL at the time of an ischemic stroke. Despite the recommendation for intensive LDL lowering with DM and heart disease, a large portion of patients with these conditions were poorly controlled. Achieving guideline adherence for lipid control could reduce the stroke rate, especially for those with DM and prior heart disease.