Changes in serum lipid measurements following acute ischaemic stroke

Strong observational and interventional evidence exists linking hypercholesterolaemia terolaemia and coronary heart disease, such that lowering total cholesterol significantly reduces cardiovascular morbidity and mortality. Increasingly, data LDL cholesterol suggest that hypercholesterolaemia is also an important factor in cerebrovascular atherosclerosis, and possibly for subsequent ischaemic stroke. Measurement of serum cholesterol fractions following acute myocardial infarction must be performed within the first 48 h or delayed for 3 months because serum cholesterol levels significantly fall during the first week. We have studied the temporal changes in serum cholesterol fractions and triglycerides following ischaemic stroke in 72 patients. Significant falls in total cholesterol (TC) as well as HDL and LDL cholesterol were seen 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 haemorrhagic stroke. We conclude that lipid profiles should be assessed within 48 h of stroke onset or delayed for 3 months to avoid inaccurate measurement. Appropriate measurement of serum lipids is important in patients with ischaemic stroke, as subsequent treatment may reduce further coronary and, possibly, cerebral ischaemic events.