Differences of Lipid Profile Among Ischemic and Hemorrhagic Stroke Patients in a Tertiary Hospital in Riyadh, Saudi Arabia: A Retrospective Cohort Study

Abstract

Objective This study aims to compare the serum lipid profiles of patients with ischaemic and hemorrhagic strokes. Study design This was a retrospective, comparative study. Place and duration of the study The study was conducted at Military Hospital, Riyadh, from January 1, 2018, to December 31, 2020. Methodology Patients with a diagnosis of stroke who presented to the emergency department and was confirmed to have ischemic or hemorrhagic strokes by computed tomography (CT) from January 1, 2018, to December 31, 2020. This study was based on data extracted from an electronic hospital information system (BESTCare) of patients presenting to King Abdulaziz Medical City, National Guard Health Affairs, which is a tertiary medical center in Riyadh, Saudi Arabia. Patients who lack lipid profile reading within six months before the incident or had a traumatic hemorrhagic stroke were excluded from the study. All these variables were included in the study: age, gender, height, weight, date of the incident, date of last lipid profile results, type of stroke, comorbidities, on a statin or not, and lipid profile including (high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol, and triglycerides). Microsoft Excel 2019 (Microsoft Corporation, Redmond, WA) was used for data entry and data cleaning, and Statistical Package for the Social Sciences (SPSS) version 23 (IBM Corp., Armonk, NY) was used for data analysis and visualization of the results. Results The mean age of presentation of stroke was 68±13, 59% of patients were males, and 41% were females. BMI ranged from 30±8. Obesity (BMI 30 or above) was predominant in both stroke subtypes. Among all patient comorbidities, hypertension was the most predominant. Diabetes was present in 71% of the population. Of the participants in this study, 114 had ischemic stroke and 87 had a hemorrhagic type. A comparison of the serum lipid profile of two categories of strokes showed no statistical significance in serum values of total cholesterol, triglycerides, and LDL-C in ischemic and hemorrhagic stroke patients.

Comparison of circulating lipid profiles, D-dimer and fibrinogen levels between hypertensive patients with and without stroke

“…On the other hand, our study demonstrated no significant difference between the ischemic and hemorrhagic stroke groups in the serum values of other lipid components (LDL-C, HDL-C, TG). This finding agrees with previous studies that found no statistical significance in the serum values of TG and LDL-C between ischemic and hemorrhagic stroke, although there were a significantly lower HDL-C levels in the former than the latter [ 54 , 61 ]. However, numerous studies have found significant variations in such lipid components with stroke type [ 58 , [62] , [63] , [64] ].…”

“…In contrary, an inverse relationship between TC and hemorrhagic stroke has been observed in other studies [ [56] , [57] , [58] ]. In several other reports, TC was not identified to be associated or showed only weak relationships with types of stroke [ 52 , [59] , [60] , [61] ].…”

Procalcitonin as a prognostic marker in patients with acute ischemic stroke

“…In our study, the average TLC was 9.9X109/L, the average RNC was 67.7%, the average TC was 174 mg/dL, the average TG was 144.4 mg/dL, the average LDL was 101 mg/dL, the average HDL was 44.4 mg/dL, the average bilirubin was 1.1 mg/dL, the average direct bilirubin was 0.2 mg/dL, the average ALT was 18.5 U/ While Alkhaneen et al found that the fasting serum lipid profile of 114 ischemic stroke patients revealed elevated serum total cholesterol in 23.7% of patients, with a mean serum total cholesterol of 4.3 mmol/L, we found that the proportion of patients with elevated serum total cholesterol was significantly lower. 32 For patients with follow-up, the Modified Rankin Scale (mRS) revealed that 32.4% had no major impairment, 41.2% had little disability, 7.4% had moderate disability, 11.8% had moderately severe disability, and 7.4% had passed away. All patients were divided into two groups: those with favourable outcomes (mRS scores 2) and those with unfavourable outcomes (mRS scores 3).…”

Frequency of Deranged Lipid Profile in Patients with Stroke

“…According to some studies, a significant portion of stroke patients have aberrant lipid profiles, with differences between ischemic and hemorrhagic strokes noted. 12 The association between cholesterol and stroke, particularly hemorrhagic stroke, presents an inverse relationship, distinct from the direct link seen in coronary heart disease. Understanding these distinctions is crucial to tailoring lipid-lowering therapies effectively, potentially reducing stroke incidence and related mortality rates.…”