Abstract | BACKGROUND AND OBJECTIVES: METHODS: The Tokyo Women's Medical University Stroke Registry is an ongoing prospective, observational registry in which 870 patients with acute ischemic stroke or TIA within 1 week of onset were consecutively enrolled and followed up for 1 year. Hypertriglyceridemia was defined as serum triglycerides levels of ≥150 mg/dL under fasting conditions. Significant stenosis of the cervicocephalic arteries was defined as having ≥50% stenosis or occlusion. The primary outcome was major adverse cardiovascular events, including nonfatal stroke, nonfatal acute coronary syndrome, and vascular death. RESULTS: Of 870 patients (mean age 70.1 years, male 60.9%), 217 (24.9%) had hypertriglyceridemia. High triglycerides levels were significantly associated with an increased prevalence of intracranial artery stenosis, particularly in the anterior circulation, rather than extracranial artery stenosis. Patients with hypertriglyceridemia had a greater risk of major adverse cardiovascular events than those without (annual rate 20.9% vs 9.7%; p < 0.001), even after adjustment for potential confounders, including baseline low-density lipoprotein cholesterol and statin use (adjusted hazard ratio 2.46, 95% CI 1.62-3.74). The higher risk of vascular events in patients with hypertriglyceridemia vs without hypertriglyceridemia was observed among patients with stroke of atherothrombotic origin (n = 174, annual rate 35.1% vs 14.2%; p = 0.001), those with significant intracranial artery stenosis (n = 247, annual rate 29.9% vs 14.7%; p = 0.006), and those with significant extracranial carotid artery stenosis (n = 123, annual rate 23.0% vs 9.4%; p = 0.042). In contrast, hypertriglyceridemia was not predictive of recurrent vascular events in patients with cardioembolic stroke (n = 221, annual rate 19.1% vs 10.5%; p = 0.18). DISCUSSION: TRIAL REGISTRATION INFORMATION: UMIN000031913 at upload.umin.ac.jp. CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that in patients with atherothrombotic stroke, hypertriglyceridemia is associated with an increased risk of major cardiovascular events.
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Authors | Takao Hoshino, Kentaro Ishizuka, Sono Toi, Takafumi Mizuno, Ayako Nishimura, Sho Wako, Shuntaro Takahashi, Kazuo Kitagawa |
Journal | Neurology
(Neurology)
Vol. 98
Issue 16
Pg. e1660-e1669
(04 19 2022)
ISSN: 1526-632X [Electronic] United States |
PMID | 35296551
(Publication Type: Journal Article)
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Copyright | © 2022 American Academy of Neurology. |
Chemical References |
- Hydroxymethylglutaryl-CoA Reductase Inhibitors
- Triglycerides
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Topics |
- Aged
- Constriction, Pathologic
(complications)
- Female
- Humans
- Hydroxymethylglutaryl-CoA Reductase Inhibitors
- Hypertriglyceridemia
(complications, epidemiology)
- Ischemic Stroke
- Male
- Prognosis
- Prospective Studies
- Risk Factors
- Stroke
(complications, epidemiology)
- Triglycerides
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