An Observational Study of Association of Extended Lipid Profile with Types of Stroke and Its Outcomes

Background: Alterations in the lipid profile can elevate the risk of ischemic stroke (IS). A connection exists between serum lipid concentrations and short-term mortality. Serum cholesterol levels in IS and hemorrhagic stroke (HS) should be assessed for prescribing lipid-lowering medication, which can improve outcomes. The primary objective was to assess the association between various parameters of lipid profile and stroke types (i.e. ischemic and hemorrhagic). The secondary objective was to determine risk factors of mortality following stroke, and the correlation of lipid profile with carotid intimal medial thickness (CIMT) among stroke patients. Material and Methods: An observational study was carried out from June 2019 to July 2021 on 200 stroke patients. Each patient's serum extended lipid profile was measured. MRI/MRI angiography, CT scan, as well as Carotid Doppler were performed. Outcomes were noted in terms of mortality. Determination of risk factors of mortality was done by performing logistic regression. A p-value below 0.05 was deemed to be significant. Results: Both HS and IS groups had comparable total cholesterol (180 vs. 204 mg/dL), triglycerides (146 vs. 173 mg/dL), VLDL (29.2 vs. 34.6 mg/dL), LDL (113.2 vs. 135.4 mg/dL), and HDL (36 vs. 36 mg/dL) (P>0.05 in all). Among patients with HS, CIMT showed a significant positive correlation with TG (r= 0.574, p=0.046) and a significant negative correlation with HDL (r=-0.512, p=0.046), while among patients with IS, CIMT showed a significant positive correlation with VLDL (r= 0.519, p=0.036). On performing univariate regression, diastolic blood pressure, apolipoprotein A1, and apolipoprotein B were significant risk factors of mortality with odds ratios of 1.053, 0.939 and 1.036, respectively. Conclusion: The monitoring of extended lipid profile seems of significance in patients with stroke since higher levels of apolipoprotein A1 and B increase the risk of mortality. Moreover, higher TG, higher VLDL and lower HDL were associated with higher CIMT and atherosclerosis. Keywords: Cholesterol, Ischemic Stroke, Hemorrhagic Stroke, Dyslipidemia, Mortality.