HDL-C a potential marker of functional outcome in ischaemic stroke

Elevated concentrations of high-density lipoprotein cholesterol (HDL-C) are associated with favourable functional recovery in patients with ischaemic stroke, as suggested in a recent study.

The study included 865 patients (mean age 70.2 years, 61.1 percent male) with ischaemic stroke, consecutively enrolled within 1 week of symptom onset and followed up for 1 year. Patients were grouped into three, according to tertiles of serum HDL‐C levels: <47 mg/dL (tertile 1), 47–60 mg/dL (tertile 2), and >60 mg/dL (tertile 3).

A composite of major adverse cardiovascular events, including nonfatal stroke, nonfatal acute coronary syndrome, major peripheral artery disease, and vascular death, was the primary outcome. The secondary outcome was the modified Rankin scale score, with scores of 0–2 defined as good functional outcome.

Patients in tertile 3 were more likely to be older, female, nonsmokers and less likely to have diabetes and coronary artery disease. The risk of major adverse cardiovascular events did not significantly differ across the three groups, with annual rates of 17.5 percent in tertile 1, 11.2 percent in tertile 2, and 12.4 percent in tertile 3 (p=0.11).

However, tertile 3 vs 1 was associated with good functional outcomes at 3 months (adjusted odds ratio [OR], 1.71, 95 percent confidence interval [CI], 1.03–2.83) and 1 year (adjusted OR, 1.60, 95 percent CI, 1–2.57).