INFLUENCE OF CHOLESTEROL ON SURVIVAL AFTER STROKE - RETROSPECTIVE STUDY

Objective: To investigate the association between Serum cholesterol co ncentration and cerebrovascular disease. Design: Retrospective study. Setting: Acute stroke unit of inner city general hospital. Subjects: 9 77 patients with acute stroke. Main outcome measures: Serum total chol esterol concentration, type of stroke investigated by computed tomogra phy or magnetic resonance imaging, three month outcome (good (alive at home) or bad (dead ol in care)), long term mortality Results: After a djustment for known prognostic factors, higher serum cholesterol conce ntrations were associated with reduced long term mortality after strok e (relative hazard 0.91 (95% confidence interval 0.84 to 0,98) per mmo l/l increase in cholesterol) independently of stroke type, vascular te rritory and extent, age, and hyperglycaemia. Three month outcome was a lso influenced independently by serum cholesterol (P = 0.024). Conclus ions: Our data suggest an association between poor stroke outcome and lower serum cholesterol concentration. Until a prospective controlled study has confirmed the benefits of lowering cholesterol concentration in elderly subjects, the application of cholesterol lowering guidelin es cannot be justified as secondary prevention of acute stroke.