| Abstract: |
SUMMARY AND CONCLUSIONStroke is a major public health problem that ranks in the top four causes of death in most countries. Stroke is the leading cause of severe neurologic disability and results in enormous costs and lost productivity. 80% of strokes are due to ischemia; the remainder is due to hemorrhage. Dyslipidemia is one of the major risk factors for ischemic stroke; as proven by numerous studies.This cross-sectional, observational and analytic study which was carried out in the stroke subunit of medical ICU, Faculty of Medicine, Zagazig University hospitals, during the period from May to October 2012 in order to find out the prevalence and patterns of dyslipidemia in cases of acute ischemic stroke and to study the effect of dyslipidemia and its patterns and other modifiable risk factors on mortality of ischemic stroke patients.This study included a total number of 105 subjects with acute ischemic stroke, confirmed clinically and radiologically by brain CT scan or MRI. The ages of the subjects ranged from 45 to 80 years old with mean of 63.35±7.25. 45.7% of the subjects were of female gender, while 52.3% of the subjects were of male gender. 63.8% of the subjects were of age ≤65 years, while 36.2% of subjects were of age>65 years.This study revealed that: Dyslipidemia was highly prevalent among cases of acute ischemic stroke, with significantly higher prevalence in males than females. However, we found no significant difference in prevalence of dyslipidemia in age groups below and above 65 years old. High LDL-C is the most prevalent pattern followed by high TG, high TC, and then low HDL. High TC/HDL & TG/HDL ratios showed a wide prevalence, even more frequent than each individual lipid pattern of dyslipidemia. Also, high LP (a) is widely prevalent in our study, but no significant age or gender differences are found. Dyslipidemia increased the relative risk of mortality of ischemic stroke patients by 2.8, 2.6, 1.5, 1.3, and 1.2 folds respectively. While, high TC, high LDL, high TG , low HDL, high LP (a), high TC/HDL, and high TG/HDL increased the relative risk of the mortality of ischemic stroke patients by: 3.9, 3.43, 1.96, 1.4, 1.46, 2.78, and 1.3 respectively. APACHE II score is positively correlated with dyslipidemia and high TC, while no correlation was found between GCS and dyslipidemia or its patterns. Finally, APACHE II score, GCS and high TC/HDL can be used as predictors for mortality of ischemic stroke patients.Conclusion: dyslipidemia is one of the major risk factors, which is widely frequent among cases of ischemic stroke, and high LDL is the most frequent patterns of dyslipidemia in ischemic stroke subjects. High TC/HDL ratio seems to be a dependable indicator for dyslipidemia as a risk factor of ischemic stroke. APACHE II score is positively correlated with dyslipidemia and high TC, while no correlation was found with GCS. High LP (a) is widely frequent among ischemic stroke patients; this emphasizes its role as a risk factor of ischemic stroke. High TC/HDL ratio can predict mortality of acute ischemic stroke patients; though APACHE II score takes the upper hand.
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