Abstract
Objectives: To assess, correlate and compare the levels of various parameters of lipid profile in patients with ischemic and hemorrhagic stroke. Methods: The study was conducted as an observational study at the Department of Medicine, People’s Hospital on 100 patients presenting with focal neurological deficit, altered sensorium, or with CT/MRI findings suggestive of stroke during the study duration of 18 months. Based upon the type of stroke, patients were categorized into two groups, i.e. ischemic stroke and hemorrhagic stroke. NCEP-ATP III guidelines were used for estimation of dyslipidemia and association of dyslipidemia was observed with type of stroke. Results: Of 100 cases, ischemic stroke was documented in 74% cases, whereas 26% of patients presented with hemorrhagic stroke. Two groups were comparable in terms of baseline characteristics (p>0.05). Mean total cholesterol levels and total cholesterol and total cholesterol to HDL ratio was significantly higher in ischemic stroke as compared to hemorrhagic stroke (p<0.05). However, mean serum HDL level was significantly lower in patients with ischemic stroke as compared to hemorrhagic stroke (p<0.05). Total cholesterol, and total cholesterol: HDL ratio showed statistically significantly negative correlation with type of stroke and positive correlation was noted between HDL and hemorrhagic stroke. Conclusion: The prevalence of stroke is rising rapidly and the age of presentation of stroke is reducing. Ischemic stroke is the most common type of stroke whereas hemorrhagic stroke is less commonly observed in less than one-third of patients. Dyslipidemia is a significant risk factor for ischemic stroke. Raised Total cholesterol, and total cholesterol: HDL levels and lower HDL levels are independent predictors of ischemic stroke.
Highlights
Stroke called cerebrovascular accident or brain attack is characterized by neurological deficit which is due to acute focal injury to the central nervous system [1]
All the patients above 14yrs across both the genders presenting with focal neurological deficit, altered sensorium, and CT/MRI findings consistent with ischemic or hemorrhagic stroke were included in the study whereas patients under the age of 14 years; on lipid-lowering agents; with a past history of stroke, stroke secondary to trauma, demyelination disorders, transient ischemic attack or patients with any neurological deficit due to meningitis and encephalitis and due to other infective etiologies were excluded from the study
Out of 100 cases, ischemic stroke was documented in 74% of cases whereas 26% of patients presented with hemorrhagic stroke (Table 1)
Summary
Stroke called cerebrovascular accident or brain attack is characterized by neurological deficit which is due to acute focal injury to the central nervous system [1]. Every fourth individual over the age of 25 years is expected to experience a stroke in their lifetime. Incidence of stroke increase with age and more than 60% of strokes are reported in the age group of more than 70 years. Various risk factors predispose to the development of stroke which includes increasing age, male gender, family history, ethnicity, genetic factors, lifestyle factors (such as smoking, alcohol), low socioeconomic status, diabetes, hypertension, heart disease, hypercholesterolemia, and obesity [3]. Changes in lipid profile are considered as important risk factors in the occurrence of stroke. It has been documented that in patients with stroke, serum lipid levels are affected as a result of accompanying stress and increased production of catecholamines [4]
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