Evaluating the utility of fasting lipid panel in addition to random lipid panel in determining lipid-lowering therapy in acute ischemic stroke or TIA patients.
Clin Neurol Neurosurg
; 197: 106068, 2020 10.
Article
en En
| MEDLINE
| ID: mdl-32688096
BACKGROUND: Hyperlipidemia is one of the major risk factors for cerebrovascular disease and it is common practice to obtain fasting lipid profile prior to starting lipid lowering therapy (LLT). Recent AHA Guidelines published in 2018 allow for a non-fasting value to be used. OBJECTIVE: To determine if obtaining fasting lipid levels in addition to random lipid levels prompts changes in hyperlipidemia management of acute stroke patients. METHODS: 206 patients met the study criteria which included a diagnosis of acute ischemic stroke or transient ischemic attack on admission and availability of both random and fasting LDL levels collected within 72â¯h of each other. Patients were divided into three groups based on random LDL at admission: Group A: LDLâ¯<â¯70, Group B: LDL 70-99, and Group C: LDLâ¯≥â¯100â¯mg/dL. The dataset was analyzed to conform to the 2018 AHA/ACC guidelines using an LDL cutoff of 70â¯mg/dL. RESULTS: In 206 patients, statin management would change based on the fasting LDL level in 12 patients, 11 of whom were in Group B. Our data suggests that lipid management is more likely to change if the initial random LDL falls between 70-99â¯mg/dL as compared to a value outside of this range (Pâ¯<â¯0.001). We present a decision algorithm to guide lipid management in acute stroke patients. CONCLUSIONS: Foregoing a fasting lipid panel to guide LLT in patients with ischemic stroke is appropriate in most cases but for select patients with random LDL levels between 70 and 99, fasting lipid profile should be obtained prior to deciding upon LLT.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Ataque Isquémico Transitorio
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Inhibidores de Hidroximetilglutaril-CoA Reductasas
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Accidente Cerebrovascular Isquémico
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Lípidos
Tipo de estudio:
Clinical_trials
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Guideline
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Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Clin Neurol Neurosurg
Año:
2020
Tipo del documento:
Article
País de afiliación:
Estados Unidos
Pais de publicación:
Países Bajos