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Serum lipids after stroke

Faculty of Medicine (Dr. Mendez), The University of Western Ontario; and the Investigative Stroke Unit, Department of Clinical Neurological Sciences (Dr. Hachinski) and Lipid Research Clinic, Department of Medicine (Dr. Wolfe), University Hospital, London, Ontario, Canada.

To ascertain the appropriate time for detecting lipid abnormalities for prophylaxis, serial analyses of fasting serum lipoproteins were undertaken prospectively in men with cerebral infarction or transient ischemic attacks. Serum total cholesterol (T CHOL) and low density lipoprotein cholesterol (LDL CHOL) in cerebral infarction patients aged 50 to 69 were lowest on day 7, intermediate on day 1, and highest at 3 months, whereas very low density lipoprotein and high density lipoprotein cholesterol (HDL CHOL) changed little. The day 1 mean fasting serum HDL CHOL of cerebral infarct patients was significantly lower in subjects aged 50 to 59 than in those aged 60 to 69 (23 ± 3 versus 42 ± 5 mg/dl), and there was a corresponding higher ratio of T CHOL:HDL CHOL (12.7 ± 4.5 versus 4.7 ± 0.4, p < 0.01). Mean HDL CHOL levels were low normal to low in patients aged 50 to 69 with transient ischemic attacks. Both serum cholesterol and triglyceride levels are initially decreased in patients aged 50 to 69 with cerebral infarction, whereas only cholesterol is decreased in patients 60 to 69 with transient ischemic attacks. Important lipoprotein abnormalities may be missed in the acute phase.

Address correspondence and reprint requests to Dr. Hachinski, Investigative Stroke Unit, Department of Clinical Neurological Sciences, University Hospital, London, Ontario, Canada N6A 5A5.

Dr. Hachinski is a Research Associate of the Heart & Stroke Foundation of Ontario.

Dr. Mendez received the G. Milton Shy Award of the American Academy of Neurology for this work.

Received October 23, 1985. Accepted for publication in final form July 2, 1986.

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