Lower Levels of High-density Lipoprotein Cholesterol on Admission and A Recurrence of Ischemic Stroke: A 12-month Follow-up of the Fukuoka Stroke Registry

Abstract

Despite recent progress in treatments for secondary prevention, ischemic stroke recurs in 8% to 12% of stroke survivors. We investigated the predisposing factors associated with recurrence within the first 12 months after an ischemic event to explore more effective preventive strategies. Between June 2007 and April 2008, acute (within 7 days of onset) ischemic stroke patients were registered in the Fukuoka Stroke Registry (FSR), a multicenter, prospective, observational database. The clinical characteristics on admission were analyzed, and the patients were followed for 12 months. Two hundred sixty patients (151 males and 109 females, 71 ± 11 years of age) were registered; 25 (9.6%) had recurrence of ischemic stroke during the follow-up period. Kaplan-Meier curve analysis revealed a significant difference in recurrence-free survival between patients with high-density lipoprotein (HDL) cholesterol <40 mg/dL on admission and those with HDL cholesterol ≥ 40 mg/dL (P = .042). Adjusted multivariate logistic regression analysis showed that age (odds ratio 1.06; 95% CI, 1.00-1.11; P = .035) and HDL cholesterol <40 mg/dL (odds ratio 2.73; 95% CI, 1.01-7.38; P = .048) on admission were independently associated with a recurrence of ischemic stroke within 12 months of the initial onset. Aging and low HDL cholesterol levels are considered independent risk factors for a recurrence of ischemic stroke.