Authors : Binod Kumar Sah; Birendra Kumar Yadav; Priya Yadav; Rajesh Rokaya; Aabishkar Subedi; Bibek Joshi; Dr. Chanda Karki

Volume/Issue : Volume 9 - 2024, Issue 7 - July

Google Scholar : https://tinyurl.com/4kw9trkd

Scribd : https://tinyurl.com/582cz3vw

DOI : https://doi.org/10.38124/ijisrt/IJISRT24JUL1362

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

Abstract : Introduction: Ischemic stroke takes place when the blood flow cessation endures for more than a few minutes leading to brain tissue infarction. After ischemic heart disease, ischemic stroke is the second most common cause of death worldwide and one of the top five diseases based on DALYs (disability-adjusted life years) in Nepal. Though dyslipidemia is a major risk factor for coronary heart disease, it has an unclear role in the pathogenesis of ischemic stroke. In a patient with a previous ischemic stroke, statins reduce the risk of ischemic stroke. So, this study analyses the plasma prevalence of total cholesterol (TC), low-density lipoprotein (LDL), High-density lipoprotein (HDL), and triglyceride (TG) in patients with acute non-cardioembolic ischemic stroke and their association with different non-modifiable risk factors (age, gender & family history) and modifiable risk factors (diabetes, hypertension, obesity, smoking & alcohol intake).  Materials and Method: This is a descriptive and analytical cross-sectional hospital-based study carried out from December 5th, 2021 to December 4th, 2022 including 80 patients admitted to Chitwan Medical College, Chitwan, with a diagnosis of acute ischemic stroke. All the patients underwent a detailed history, physical examination, and baseline investigations including fasting lipid profile along with CT- scan/MRI head. The fasting lipid profile was done within the first 24 hours of hospitalization. Data was entered in MS Excel 2013 and converted it into SPSS 26 for statistical analysis.  Result: A total of 80 patients with the diagnosis of acute ischemic stroke were enrolled. Out of them, 37 (46.25%) were female and 43 (53.75%) were male. A total number of 71 (88.75%) patients were from more than or equal to 55 years of age group and 9 (11.25%) patients were from less than 55 years of age group. The mean age ± standard deviation of male and female patients was 66.69 ±9.14 years and 68.54 ±14.96 respectively. Overall, derangement in serum lipid profile (dyslipidemia) was present in 63.75% of the patients. Among the total cases, high TC is found in 18 patients (22.5%), TG in 24 patients (30%), high LDL is found in 16 patients (20%), and low HDL is found in 23 patients (28.75%).  Conclusion: The study highlights hypertriglyceridemia as the leading dyslipidemia in ischemic stroke patients, showing gender and age variations in prevalence. It confirms dyslipidemia's role in brain vascular changes, notably in the Middle Cerebral Artery, and its link to carotid artery stenosis severity. Despite common risk factors, their direct association with dyslipidemia remains statistically insignificant, stressing the need for focused lipid management to mitigate stroke risks.

Keywords : Serum Lipid Profile, Ischemic Stroke, Dyslipidemia.

References :

1. Ng, Y. S., Stein, J., Ning, M., & Black-Schaffer, R. M. (2007). Comparison of clinical characteristics and functional outcomes of ischemic stroke in different vascular territories. Stroke, 38(8), 2309-2314.
2. Szabo, K., Kern, R., Gass, A., Hirsch, J., & Hennerici, M. (2001). Acute stroke patterns in patients with internal carotid artery disease: a diffusion-weighted magnetic resonance imaging study. Stroke, 32(6), 1323-1329.
3. Zhu, C. Z., & Norris, J. W. (1990). Role of carotid stenosis in ischemic stroke. Stroke, 21(8), 1131-1134.
4. Badea, R., Terecoasa, E., Ribigan, A., Dimitriade, A., Carp, A., Dorobat, B., ... & Bajenaru, O. (2020). Factors Associated with Severe Carotid Artery Stenosis in a Population with One of the Highest Incidences of Ischemic Stroke in Europe– Single National Center Analysis. Maedica, 15(3), 339.
5. Shaik, M. M., Loo, K. W., & Gan, S. H. (2012). Burden of stroke in Nepal. International Journal of Stroke, 7(6), 517-520.
6. Park, J. H., Lee, J., & Ovbiagele, B. (2014). Nontraditional serum lipid variables and recurrent stroke risk. Stroke, 45(11), 3269-3274. 46
7. Freiberg, J. J., Tybjaerg-Hansen, A., Jensen, J. S., & Nordestgaard, B. G. (2008). Nonfasting triglycerides and risk of ischemic stroke in the general population. Jama, 300(18), 2142-2152.
8. Kurth, T., Everett, B. M., Buring, J. E., Kase, C. S., Ridker, P. M., & Gaziano, J. M. (2007). Lipid levels and the risk of ischemic stroke in women. Neurology, 68(8), 556-562.
9. Siddeswari, R., Manohar, S., Sudarsi, B., Suryanarayana, B., Kumar, S. P., & Abhilash, T. (2015). Pattern of dyslipidemia in ischemic stroke. Journal of Medical & Allied Sciences, 5(2), 26.
10. Adams, R. J., Albers, G., Alberts, M. J., Benavente, O., Furie, K., Goldstein, L. B., ... & Schwamm, L. H. (2008). Update to the AHA/ASA recommendations for the prevention of stroke in patients with stroke and transient ischemic attack. Stroke, 39(5), 1647-1652.
11. Thapa, A., Bidur, K. C., Shakya, B., Yadav, D. K., Lama, K., & Shrestha, R. (2018). Changing epidemiology of stroke in Nepalese population. Nepal Journal of Neuroscience, 15(1), 10-18.