Is Higher Serum Total Cholesterol Level Associated With Better Long-Term Functional Outcomes After Noncardioembolic Ischemic Stroke?

Abstract

Pan S-L, Lien I-N, Chen TH. Is higher serum total cholesterol level associated with better long-term functional outcomes after noncardioembolic ischemic stroke? Objective To investigate the prognostic effects of the serum total cholesterol (TC) levels on long-term functional outcomes in patients with first-time noncardioembolic ischemic stroke. Design Cohort study. Setting Referral center. Participants Patients (N=109) with first-time ischemic stroke. Interventions Not applicable. Main Outcome Measure Serial Barthel Index (BI) scores at onset; 2 weeks; and 1, 2, 4, and 6 months after stroke. We analyzed the impact of the serum TC level and other clinical factors on the repeated measurements of BI scores at these 6 time points by using a linear mixed regression model. Results Taking correlation across repeated measurement of BI scores, the TC level, baseline BI, follow-up time, and infarct size were identified as significant predictors for serial BI scores. Higher TC levels correlated with better functional outcomes. A 1-unit (mmol/L) increase in the TC caused a 3.12 (95% confidence interval [CI], .79–5.46) increase in the BI score after controlling for other clinical factors such as age, baseline functional status, and size of infarct. An elevation of 1 unit of baseline BI led to a .49 increase (95% CI, .38–.59) per unit in subsequent BI scores. A small infarct (<1cm) had higher BI scores than larger infarct by 9.09 (95% CI, 2.03–16.16). Conclusions The serum TC level measured at the acute stage of noncardioembolic ischemic stroke is an independent predictor for long-term functional outcomes.