The Management of LDL Cholesterol and Predictors of Goal Achievement in Stroke Patients in China: A Cross-Sectional Study.

Abstract

To assess the management of low-density lipoprotein cholesterol (LDL-C) in patients suffering from ischemic stroke within 6-12months and explore the predictors of the achievement of LDL-C target. This study was a nation-wide, multicenter, cross-sectional study conducted from July 2013 to August 2013 in mainland China. Patients who had an ischemic stroke within 6-12months and were more than 18year old were consecutively included into this study. All data referred to personal information, medical history, medication and results from laboratory tests were collected by face-to-face questionnaires, physical examination and blood tests. The predictors for the achievement of LDL-C target (<1.8mmol/L or <70mg/dL) were analyzed by the multivariate analysis. A total of 3956 cases from 56 centers who suffered from ischemic stroke within 6-12months were finally included into this study. The average serum level of LDL-C in all patients was 2.42±0.91mmol/L with a median of 2.30mmol/L and the total LDL-C goal achievement rate was 27.4% (95% CI: 26.0%-28.8%). Lipid-lowering therapy (odds ratio [OR]=3.54, 95% CI: 2.879-4.388) was the most significant predictor for LDL-C target achievement and female (OR=0.64, 95% CI: 0.526-0.777), current smoking (OR=0.714, 95% CI: 0.571-0.892), and the history of dyslipidemia (OR=0.577, 95% CI: 0.497-0.668) were other three important negative factors for the LDL-C goal achievement. Although lipid modulation is recommended as an important intervention for stroke patients in the international guidelines, the goal achievement of LDL-C is still very low in this population in mainland China. The modifiable predictors including the use of lipid-lowering medication and smoking cessation should be improved in secondary prevention of stroke.