Evaluating the utility of fasting lipid panel in addition to random lipid panel in determining lipid-lowering therapy in acute ischemic stroke or TIA patients

2020 ◽  
Vol 197 ◽  
pp. 106068
Author(s):  
Usman Shehzad ◽  
Abhinay Tumati ◽  
Ruth A. Reinsel ◽  
Dharampreet Singh ◽  
Dazzle Dadra ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Lowering Therapy ◽  
Lipid Panel

Abstract P560: Delipid Extracorporeal Lipoprotein Filter System: A New Lipid-Lowering Therapy for Acute Ischemic Stroke Patients

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Yuqiong Jiao ◽  
Ting Ye ◽  
Xiang Han
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Plasma Lipids ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Adsorption System ◽  
Stroke Patients ◽  
Safety Parameters

Objectives: The purpose of this study was to illustrate a new low-density lipoprotein cholesterol (LDL-C) adsorption system, Delipid Extracorporeal Lipoprotein filter from Plasma (DELP) system, and evaluate its safety and efficacy in acute ischemic stroke patients. Methods: This is an observational study of 22 acute ischemic stroke patients who underwent DELP treatment from March to August 2019. The DELP system was composed of a plasma filter JX-DELP, a COM.TEC cell separator and Tubing P1R Plasma Treatment Set. Clinical data and laboratory results including plasma lipids and some safety parameters before and after the apheresis were collected and analyzed. Results: The present study included 22 patients (15 males, 7 females, 59.95±13.71 years). The mean LDL-C was significantly reduced from 3.36±0.64 mmol/L to 2.30±0.53 mmol/L (31.5%, p <0.001, n=22) during a single DELP treatment, and from 3.59±0.48 mmol/L to 1.85±0.50 mmol/L (48.2%, p <0.001, n=13) after two apheresis, respectively. No clinically relevant changes were observed in hematologic safety parameters during DELP treatments. Conclusions: We concluded that the new LDL-C adsorption system is a promising method for timely and controllable LDL-C administration in acute ischemic stroke patients in view of its high efficacy, simple operation, and safety.

scholarly journals Statins in patients with acute ischemic stroke: when we should start therapy?

2021 ◽  
Vol 27 (1) ◽  
pp. 16-28
Author(s):  
S. N. Yanishevskiy ◽  
I. B. Skiba ◽  
A. Y. Polushin
Keyword(s):  
Ischemic Stroke ◽  
Clinical Practice ◽  
Acute Onset ◽  
Lipid Lowering ◽  
Original Position ◽  
Optimal Time ◽  
Lipid Lowering Therapy ◽  
Lowering Therapy ◽  
Different Populations ◽  
Exact Timing

Lipid-lowering therapy is known to be an important part of ischemic stroke secondary prevention, however, the exact timing of its initiation or re-starting in the patients with ischemic stroke is not yet defined strictly. Accumulating evidence of pleiotropic (i. e. non-lipid-lowering) effects of statins in various conditions, including ischemia, urges their implementation in the clinical practice. In this review, we discuss the evidence on the effectiveness of early statin introduction in different populations of patients with ischemic stroke. We also attempt to define our original position on the optimal time after the acute onset of neurological symptoms to introduce lipid-lowering therapy.

Optimization of lipid-lowering therapy in patients after ischemic stroke. Resolution of the Council of Experts

2020 ◽  
Vol 120 (6) ◽  
pp. 152
Author(s):  
I.A. Vozniuk ◽  
N.A. Shamalov ◽  
M.V. Ezhov ◽  
O.V. Tikhomirova ◽  
V.S. Gurevich ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Lowering Therapy

scholarly journals Lipid Testing and Lipid-Lowering Therapy in Hospitalized Ischemic Stroke and Transient Ischemic Attack Patients

Stroke ◽  
2006 ◽  
Vol 37 (1) ◽  
pp. 44-49 ◽  
Author(s):  
Andrew J. Mullard ◽  
Mathew J. Reeves ◽  
Bradley S. Jacobs ◽  
Rashmi U. Kothari ◽  
Gretchen L. Birbeck ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Transient Ischemic Attack ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Lowering Therapy ◽  
Lipid Testing ◽  
Ischemic Attack

Abstract P462: Intensive Lipid Lowering Therapy May Lead to Worse Outcomes of Intracerebral Hemorrahge

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Tianping Tang ◽  
Ligong Zhang ◽  
Kai Zhang ◽  
Xingquan Zhao ◽  
Shimeng Liu
Keyword(s):  
Ischemic Stroke ◽  
Intraventricular Hemorrhage ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Current Evidence ◽  
Lipid Lowering Therapy ◽  
Lowering Therapy ◽  
Bleeding Volume ◽  
Medical Histories

Background: Intensive Lipid-lowering therapy (ILLT) is a crucial strategy for secondary prevention of ischemic stroke. While current evidence of the risks of intracerebral hemorrhage (ICH) after ILLT were contradictory; morever, insights into the associations between ILLT and the outcomes of ICH were also limited. Methods: Data of consecutive patients with acute ICH and histories of ischemic stroke at an academic stroke center from 2017 to 2019 were retrospectively collected. The study patients were classifed according to their baseline low-density lipoprotein cholesterol (LDL-c) levels: <1.8 mmol/L vs. LDL-c≥1.8 mmol/L. Results: A total of 197 patients were included in the study, 31 of them had LDL-c <1.8 mmol/L and 166 had LDL-c≥1.8 mmol/L. We did not tested any significant differences regarding the demographic characteristics or the medical histories (Table 1). Medians of baseline National Institutes of Health Stroke Scale (NIHSS) scores (8 vs. 9, p=0.79) and ICH scores (1 vs.1 , p=0.26) were similar. But patients with LDL-c<1.8 mmol/L had higher bleeding volume (11 (19) vs. 10 (52), p=0.03) and higher risks of secondary intraventricular hemorrhage (13% vs. 4%, p=0.03) (Table 2).Outcomes of the ICH events at discharge were generally similar (Table 3), except that patients with LDL-c≥1.8 mmol/L had significant improvements in their NIHSS scores at discharge (estimated change in means: -2.4, 95% [-3.9, -0.9] ), than patients with LDL-c<1.8 mmol/L (estimated change in means: -1.4, 95% CI [-4.7, 0.5]). Conclusions: Achieving LDL-c<1.8 mmol/L was associated with bigger bleeding volume, higher risks of secondary intraventricular hemorrhage, and worse neurological improvements.

scholarly journals Meta-Analysis of Dyslipidemia Management for the Prevention of Ischemic Stroke Recurrence in China

2020 ◽  
Vol 11 ◽  
Author(s):  
Kang-Ning Chen ◽  
Li He ◽  
Lian-Mei Zhong ◽  
Yu-Qin Ran ◽  
Yan Liu
Keyword(s):  
Ischemic Stroke ◽  
Recurrent Stroke ◽  
Meta Analysis ◽  
Blood Lipid ◽  
Lipid Lowering ◽  
Stroke Recurrence ◽  
Lipid Lowering Therapy ◽  
Stroke Patients ◽  
Control Groups ◽  
Lowering Therapy

Background: The benefit of blood cholesterol reduction for secondary prevention of ischemic stroke remains undetermined in Chinese patients. The purpose of this meta-analysis was to determine whether lipid-lowering agents including statins, fibrates, nicotinic acid, and ezetimibe reduced the risk of recurrent stroke in ischemic stroke patients in China and whether such findings could inform treatment decisions for blood lipid-lowering treatment in China.Methods: The English electronic databases PubMed, EMBASE, Cochrane Library and Chinese databases CNKI, Sino-Med, Wan Fang, and VIP were searched for studies published between January 1990 and April 2020. This meta-analysis included published data from trials that randomly assigned patients to groups treated with either blood lipid-lowering regimens or placebo. Effect comparisons were made using fixed effects model in meta-analysis and linear and spline regression were performed to identify the relative risk of stroke recurrence. The primary outcome was the reduction of total ischemic stroke events, and relative risk values were obtained using a risk prediction equation developed from the control groups of the included trials.Results: Five studies including 4,999 individuals with available data met the inclusion criteria. Relative to the control groups, the pooled estimated odds ratio (OR) for recurrent stroke among those who received lipid-lowering therapy was 0.79 (95% confidence interval [CI]: 0.63–1.00). A 50% or greater reduction in low-density lipoprotein cholesterol (LDL-C) significantly reduced the risk of ischemic stroke recurrence (OR: 0.15 [95% CI: 0.11–0.20]). The overall beneficial effect of statin therapy was confirmed to prevent ischemic stroke with an OR of 0.51 (95% CI: 0.36–0.72).Conclusions: Effective lipid-lowering therapy could decrease the blood LDL-C level, which had a protective effect against stroke recurrence. These results support the use of predicted baseline cerebrovascular disease risk equations to inform decisions regarding blood lipid-lowering treatment in ischemic stroke patients in China.

scholarly journals Carotid endarterectomy in acute ischemic stroke

2018 ◽  
Vol 22 (1) ◽  
pp. 66 ◽  
Author(s):  
A. N. Kazantsev ◽  
N. N. Burkov ◽  
R. S. Tarasov ◽  
A. I. Anufriev ◽  
A. R. Shabaev ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Surgical Treatment ◽  
Acute Ischemic Stroke ◽  
Carotid Endarterectomy ◽  
Conflict Of Interest ◽  
Lipid Lowering ◽  
Cerebrovascular Event ◽  
Lipid Lowering Therapy ◽  
Advantages And Disadvantages ◽  
Satisfactory Outcome

<p>Currently, there are no clear domestic and foreign recommendations for cerebral revascularization, also missing is a definite decision on determining the timing and possibility of carotid endarterectomy in acute ischemic stroke. A set of measures aiming at obtaining a satisfactory outcome of carotid endarterectomy in the acute ischemic cerebrovascular event is developed. To prevent hyperperfusion complications, a temporary shunt, low doses of unfractionated heparin, adequate antiplatelet, hypotensive and lipid-lowering therapy are used. The main advantages and disadvantages of all modern methods of surgical treatment of this condition are presented.</p><p>Received 22 August 2017. Revised 7 December 2017. Accepted 11 December 2017.</p><p><strong>Funding:</strong> The study was supported by the Siberian Branch of Russian Academy of Sciences within the framework of the fundamental research package program.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p><p><strong>Author contributions</strong><br />Drafting the article: A.N. Kazantsev<br />Resources: A.R. Shabayev<br />Artistic design: N.N. Burkov<br />Critical revision of the article: A.I. Anufriyev, A.V. Mironov, V.Yu. Kheraskov<br />Surgical treatment: A.N. Kazantsev<br />Assistance in surgery: N.N. Burkov, A.R. Shabayev<br />Revascularization tactic selection: A.I. Anufriyev, A.V. Mironov, V.Yu. Kheraskov<br />Neurological examination: E.V. Ruban<br />Final approval of the version to be published: A.N. Kazantsev, N.N. Burkov, R.S. Tarasov, A.I. Anufriyev, A.R. Shabayev, E.V. Ruban, A.V. Mironov,<br />V.Yu. Kheraskov</p>

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