CHANGES IN SERUM-LIPID MEASUREMENTS FOLLOWING ACUTE ISCHEMIC STROKE

Strong observational and interventional evidence exists linking hyperc holesterolaemia terolaemia and coronary heart disease, such that lower ing total cholesterol significantly reduces cardiovascular morbidity a nd mortality. Increasingly, data LDL cholesterol suggest that hypercho lesterolaemia is also an important factor in cerebrovascular atheroscl erosis, and possibly for subsequent ischaemic stroke. Measurement of s erum cholesterol fractions following acute myocardial infarction must be performed within the first 48 h or delayed for 3 months because ser um cholesterol levels significantly fall during the first week. We hav e studied the temporal changes in serum cholesterol fractions and trig lycerides following ischaemic stroke in 72 patients. Significant falls in total cholesterol (TC) as well as HDL and LDL cholesterol were see n during the first week whilst levels normalised by 3 months; TC mean (SD in parentheses) mmol/l, admission vs. 1 week, 5.54 (1.32) vs. 5.13 (1.07), n = 72, 2p < 0.0001, and admission vs. 3 months, 5.54 (1.32) vs. 5.69 (1.30), n = 72, 2p = 0.21. No changes in serum triglycerides were noted. Similar changes occurred in 13 patients with primary haemo rrhagic stroke. We conclude that lipid profiles should be assessed wit hin 48 h of stroke onset or delayed for 3 months to avoid inaccurate m easurement. Appropriate measurement of serum lipids is important in pa tients with ischaemic stroke, as subsequent treatment may reduce furth er coronary and, possibly, cerebral ischaemic events.