Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Lipid management in Ischemic Stroke or Transient Ischemic Attack in China: Result from China National Stroke Registry III
First author：Yu-Yuan Xu
Corresponding author：Xia Meng
essential_information
- Person in charge：Yu-Yuan Xu
- Data Sources： CNSR-Ⅲ
- Number of papers：CNSR-Ⅲ20220177
- Published time：2023-03-08
2023-03-08
Published articles
Journal：BMJ open
Publication type: Original Article
IF(IF): 3.007
PMID: 36889830 Link To Pubmed Full text Download
Background And Purpose
Dyslipidaemia is a significant risk factor for ischemic stroke and transient ischemic attack (TIA). This study aimed to assess the management of LDL-C and the goal achievement and to investigate the association between baseline low-density lipoprotein cholesterol (LDL-C) level, lipid-lowering treatment (LLT), and stroke recurrence in patients with ischemic stroke or TIA.
Method
We derived data from the Third China National Stroke Registry (CNSR-III). The primary outcome was a new stroke, LDL-C goal (LDL-C<1.8mmol/L and LDL-C<1.4mmol/L, respectively) achievement rates, and LLT compliance within 3, 6, and 12 months. The association of baseline LDL-C level, LLT at discharge, and outcomes were assessed.
Conclusion
The LDL-C goal achievement rate has increased mildly in the stroke and TIA population in mainland China. Lowered baseline LDL-C level was significantly associated with a decreased short- and long-term risk of ischemic stroke among stroke and TIA patients. LDL-C<1.4mmol/L might be a safe standard for this population.
Main results
Among the 15,166 patients, over 90% of patients received LLT during hospitalization and 2 weeks after discharge; the LLT compliance was 84.5% at 3 months, 75.6% at 6 months, and 64.8% at 12 months. At 12 months, LDL-C goal achievement rate for 1.8mmol/L and 1.4mmol/L was 35.4% and 17.6%, respectively. LLT at discharge was associated with reduced risk of ischemic stroke recurrence (HR=0.69, 95% CI: 0.48-0.99, p=0.04) at 3 months. The rate of LDL-C reduction from baseline to 3-month follow-up was not associated with a reduced risk of stroke recurrence or major adverse cardiovascular events (MACE) at 12 months. Patients with baseline LDL-C ≤1.4mmol/L had a numerically lower risk of stroke, ischemic stroke and MACE at both 3 months and 12 months.