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Blood lipids in brain infarction subtypes.

By Pierre Amarenco, Julien Labreuche, Alexis Elbaz, Pierre-Jean Touboul, Fathi Driss, Assia Jaillard and Éric Bruckert


International audienceBACKGROUND: Little is known about the relationship between hypercholesterolaemia and specific aetiological subtypes of brain infarction (BI). METHODS: In a cross-sectional study of 492 pairs of patients with a BI proven by MRI and matched hospital controls, we determined the blood levels of triglycerides, total, HDL and LDL cholesterol, and apolipoprotein A(1) and B, in the same centralized laboratory. We performed aetiological BI subtype classification. RESULTS: Except for triglycerides, the risk of BI increased continuously with the lipid levels, without any heterogeneity between the main BI subtypes or the group on lipid-lowering therapy. The adjusted odds ratio per standard deviation in LDL cholesterol (0.93 mmol/l) was 1.74 (95% confidence interval, 1.02-2.98) in atherothrombotic strokes (n = 109) and 2.71 (95% confidence interval, 1.60-4.55) in lacunar strokes (n = 105). Eighty percent of patients were above the ATP-III guideline threshold LDL cholesterol of 2.59 mmol/l (100 mg/dl), with a major contribution of both atherothrombotic and lacunar stroke subtypes to this group. CONCLUSIONS: These findings suggest that blood lipids, particularly total and LDL cholesterol levels, are associated with all subtypes of BI, and that LDL above 2.59 mmol/l is highly prevalent

Topics: Stroke, Cerebral infarction, Atherosclerosis, Carotid stenosis, Lacunar infarction, Hypercholesterolaemia, MESH: Aged, MESH: Apolipoprotein A-I, MESH: Hypercholesterolemia, MESH: Male, MESH: Middle Aged, MESH: Peptide Fragments, MESH: Risk Factors, MESH: Apolipoproteins B, MESH: Brain Infarction, MESH: Cholesterol, MESH: Cholesterol, HDL, MESH: Cholesterol, LDL, MESH: Cross-Sectional Studies, MESH: Female, MESH: Humans, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]
Publisher: 'S. Karger AG'
Year: 2006
DOI identifier: 10.1159/000093237
OAI identifier: oai:HAL:inserm-00177130v1
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