Abstract P670: Obesity and Mortality After the First Ischemic Stroke: Is Obesity Paradox Real?

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Durgesh Chaudhary ◽  
Ayesha Khan ◽  
Mudit Gupta ◽  
Yirui Hu ◽  
Jiang Li ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Proportional Hazards Model ◽  
Obesity Paradox ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Obese Patients ◽  
Stroke Patients ◽  
Stroke Event ◽  
One Year ◽  
First Time

Introduction: Obesity is an established risk factor for ischemic stroke but the association of increased body mass index (BMI) with survival after ischemic stroke remains controversial. Many studies have shown that increased BMI has a “protective” effect on survival after stroke while other studies have debunked the obesity paradox. This study aimed at examining the relationship between BMI and all-cause mortality at one year in first-time ischemic stroke patients using data extracted from different resources including electronic health records. Methods: We analyzed consecutive ischemic stroke patients captured in the Geisinger NeuroScience Ischemic Stroke (GNSIS) database. Survival in first-time ischemic stroke patients was analyzed using Kaplan-Meier estimator, stratified by different BMI categories. The predictors of mortality at one-year were assessed using a multivariate Cox proportional hazards model. Results: Among 6,703 first-time adult ischemic stroke patients, mean age was 70.2 ±13.5 years and 52% were men. Of these patients, 24% patients were non-overweight (BMI < 25), 34% were overweight (BMI 25-29.9) and 41% were obese (BMI ≥ 30). One-year survival probability was significantly higher in overweight patients (87%, 95% CI: [85.6 - 88.4], p<0.001) and obese patients (89.5%, 95% CI: [88.4 - 90.7], p<0.001) compared to non-overweight patients (78.1%, 95% CI: [76.0 - 80.1]). In multivariate analysis, one-year mortality was significantly lower in overweight and obese patients (overweight patients- HR = 0.61 [95% CI, 0.52 - 0.72]; obese patients- HR = 0.56 [95% CI, 0.48 - 0.67]). Other significant predictors of one-year mortality were age at the ischemic stroke event (HR = 1.04 [95% CI, 1.03 - 1.04]), history of neoplasm (HR = 1.59 [95% CI, 1.38 - 1.85]), atrial fibrillation or flutter (HR = 1.26 [95% CI, 1.09 - 1.46]), heart failure (HR = 1.68 [95% CI, 1.42 - 1.98]), diabetes mellitus (HR = 1.27 [95% CI, 1.1 - 1.47]), rheumatic disease (HR = 1.37 [95% CI, 1.05 - 1.78]) and myocardial infarction ((HR = 1.23 [95% CI, 1.02 - 1.48]). Conclusion: Our results support the obesity paradox in ischemic stroke patients as shown by a significantly decreased hazard ratio for one-year mortality among overweight and obese patients in comparison to non-overweight patients.

scholarly journals Obesity and mortality after the first ischemic stroke: Is obesity paradox real?

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246877
Author(s):  
Durgesh Chaudhary ◽  
Ayesha Khan ◽  
Mudit Gupta ◽  
Yirui Hu ◽  
Jiang Li ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Proportional Hazards Model ◽  
Obesity Paradox ◽  
Hazard Ratio ◽  
Cox Proportional Hazards Model ◽  
Obese Patients ◽  
Stroke Patients ◽  
Study Results ◽  
One Year ◽  
First Time

Background and purpose Obesity is an established risk factor for ischemic stroke but the association of increased body mass index (BMI) with survival after ischemic stroke remains controversial. Many studies have shown that increased BMI has a “protective” effect on survival after stroke while other studies have debunked the “obesity paradox”. This study aimed at examining the relationship between BMI and all-cause mortality at one year in first-time ischemic stroke patients using a large dataset extracted from different resources including electronic health records. Methods This was a retrospective cohort study of consecutive ischemic stroke patients captured in our Geisinger NeuroScience Ischemic Stroke (GNSIS) database. Survival in first-time ischemic stroke patients in different BMI categories was analyzed using Kaplan Meier survival curves. The predictors of mortality at one-year were assessed using a stratified Cox proportional hazards model. Results Among 6,703 first-time ischemic stroke patients, overweight and obese patients were found to have statistically decreased hazard ratio (HR) compared to the non-overweight patients (overweight patients- HR = 0.61 [95% CI, 0.52–0.72]; obese patients- HR = 0.56 [95% CI, 0.48–0.67]). Predictors with a significant increase in the hazard ratio for one-year mortality were age at the ischemic stroke event, history of neoplasm, atrial fibrillation/flutter, diabetes, myocardial infarction and heart failure. Conclusion Our study results support the obesity paradox in ischemic stroke patients as shown by a significantly decreased hazard ratio for one-year mortality among overweight and obese patients in comparison to non-overweight patients.

scholarly journals Premature Ventricular Complexes on Screening Electrocardiogram and Risk of Ischemic Stroke

Stroke ◽  
2015 ◽  
Vol 46 (5) ◽  
pp. 1365-1367 ◽  
Author(s):  
Sunil K. Agarwal ◽  
Jennifer Chao ◽  
Frederick Peace ◽  
Suzanne E. Judd ◽  
Brett Kissela ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Racial Differences ◽  
Proportional Hazards Model ◽  
Geographic Region ◽  
Left Ventricular ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Premature Ventricular Complexes ◽  
Increased Risk

Background and Purpose— Premature ventricular complexes (PVCs) detected from long-term ECG recordings have been associated with an increased risk of ischemic stroke. Whether PVCs seen on routine ECG, commonly used in clinical practice, are associated with an increased risk of ischemic stroke remains unstudied. Methods— This analysis included 24 460 participants (aged, 64.5+9.3 years; 55.1% women; 40.0% blacks) from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study who were free of stroke at the time of enrollment. PVCs were ascertained from baseline ECG (2003–2007), and incident stroke cases through 2011 were confirmed by an adjudication committee. Results— A total of 1415 (5.8%) participants had at least 1 PVC at baseline, and 591 developed incident ischemic stroke during an average (SD) follow-up of 6.0 (2.0) years. In a cox proportional hazards model adjusted for age, sex, race, geographic region, education, previous heart disease, systolic blood pressure, blood pressure–lowering medications, current smoking, diabetes mellitus, left ventricular hypertrophy by ECG, and aspirin use and warfarin use, the presence of PVCs was associated with 38% increased risk of ischemic stroke (hazard ratio [95% confidence interval], 1.38 [1.05–1.81]). Conclusions— PVCs are common on routine screening ECGs and are associated with an increased risk of ischemic stroke.

One-Year Risk of Recurrent Stroke and Death Associated with Vertebrobasilar Artery Stenosis and Occlusion in a Cohort of 10,515 Patients

2019 ◽  
Vol 47 (1-2) ◽  
pp. 40-47 ◽  
Author(s):  
Adnan I. Qureshi ◽  
Mushtaq H. Qureshi ◽  
Li-Ming Lien ◽  
Jiunn-Tay Lee ◽  
Jiann-Shing Jeng ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Recurrent Stroke ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Large Artery ◽  
Stroke Registry ◽  
Risk Of Death ◽  
Vertebrobasilar Artery

Background: The natural history of vertebrobasilar artery (VBA) stenosis or occlusion remains understudied. Methods: Patients with diagnosis of ischemic stroke or transient ischemic attack (TIA) who were noted to have VBA stenosis based on computed tomography or magnetic resonance imaging or catheter-based angiogram were selected from Taiwan Stroke Registry. Cox proportional hazards model was used to determine the hazards ratio (HR) of recurrent stroke and death within 1 year of index event in various groups based on severity of VBA stenosis (none to mild: 0–49%; moderate to severe: 50–99%: occlusion: 100%) after adjusting for differences in demographic and clinical characteristics between groups at baseline evaluation. Results: None to mild or moderate to severe VBA stenosis was diagnosed in 6972 (66%) and 3,137 (29.8%) among 10,515 patients, respectively, and occlusion was identified in 406 (3.8%) patients. Comparing with patients who showed none to mild stenosis of VBA, there was a significantly higher risk of recurrent stroke (HR 1.21, 95% CI 1.01–1.45) among patients with moderate to severe VBA stenosis. There was a nonsignificantly higher risk of recurrent stroke (HR 1.49, 95% CI 0.99–2.22) and significantly higher risk of death (HR 2.21, 95% CI 1.72–2.83), among patients with VBA occlusion after adjustment of potential confounders. Conclusions: VBA stenosis or occlusion was relatively prevalent among patients with TIA or ischemic stroke and associated with higher risk of recurrent stroke and death in patients with ischemic stroke or TIA who had large artery atherosclerosis.

scholarly journals Anticoagulación luego de una hemorragia por úlcera péptica: riesgos de trombosis, mortalidad y sangrado recurrente

2020 ◽  
Vol 50 (1) ◽  
Author(s):  
Natalia Causada Calo ◽  
Federico Angriman ◽  
Manuel A Mahler-Spinelli ◽  
Sebastian Durán ◽  
Dante Manazzoni ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Ulcer Bleeding ◽  
Recurrent Bleeding ◽  
Peptic Ulcer Bleeding ◽  
Hazards Model ◽  
One Year

Background. Patients on chronic anticoagulation face a higher risk of peptic ulcer bleeding. In this setting, the risk-benefit equation of anticoagulation resumption remains undefined. Aims. To compare the risk of thrombosis and death between patients that resumed and did not resume anticoagulation after an index episode of peptic ulcer bleeding. The secondary objective was to compare time to re-bleeding between the groups. Methods. Retrospective cohort study of adult patients that suffered an index episode of peptic ulcer bleeding while on chronic anticoagulation. Patients were divided into two groups according to whether they resumed or not anticoagulation and were followed-up for one year. A multivariable, propensity score-adjusted Cox proportional hazards model was used to adjust for confounding. Adjusted survival curves were constructed. Results. 70 patients were included in the analysis; 64.3% were men. Median age at the time of PUB was 79 years (interquartile range (IQR): 72-83). Forty patients (57.1%) resumed anticoagulation after a median time of 15 days (IQR 5.25-41.75). Restarting anticoagulation was associated with a lower risk of thrombosis or death (hazard ratio [HR] 0.14; 95%CI 0.05-0.43) and did not increase the risk of recurrent bleeding significantly (HR 1.42; 95% CI 0.10-19.8). Conclusions. Resuming anticoagulation appears to reduce the hazard of thrombosis and death without increasing the risk of recurrent bleeding significantly.

scholarly journals Acupuncture Reduces the Risk of Dysphagia in Stroke Patients: A Propensity Score-Matched Cohort Study

2022 ◽  
Vol 15 ◽  
Author(s):  
Xuan Qiu ◽  
Xiao-Jie Yao ◽  
Sheng-Nan Han ◽  
Yun-Yun Wu ◽  
Zeng-Jian Ou ◽  
...  
Keyword(s):  
Sample Size ◽  
Lower Risk ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Rank Test ◽  
Future Research ◽  
Stroke Patients ◽  
Stroke Type ◽  
Risk Ratios

Background: Post-stroke dysphagia (PSD) affects the quality of life in stroke patients, impairs their rehabilitation ability, and causes other complications following stroke. Currently, there is currently some understanding of PSD risk factors, but its protective factors remain largely unknown.Objective: To analyze the effects of acupuncture (AP) on dysphagia in stroke patients and explore its potential as a preventive therapy.Methods: Patients with a diagnosis of stroke from 2010 to 2019 were selected and followed until 2020, utilizing factors such as age, gender, stroke location, stroke type, and baseline comorbidity. To compare the incidence of dysphagia, equal numbers of stroke patients treated with and without AP (n = 1,809) were matched by 1:1 propensity scoring. The Cox proportional hazards model and Kaplan-Meier method were used to assess the risk of dysphagia as an outcome measure.Results: The stroke patients treated with AP had a lower risk of dysphagia after adjusting for age, gender, stroke location, stroke type, and baseline comorbidity [adjusted hazard ratio (AHR) = 0.43, 95% confidence interval = 0.37–0.49] compared with those in the non-AP cohort. AP also decreased the risk of PSD among different gender groups. The risk ratios were AHR = 0.45 and AHR = 0.33 for males and females, respectively. AP also reduced the risk for PSD among different age groups. The risk ratios were AHR = 0.20, AHR = 0.37, AHR = 0.41, and AHR = 0.45 for the 18–39, 40–59, 60–79, and &gt;80 years-old groups. Regarding stroke types (ischemic, hemorrhagic, and mixed type), patients treated with AP had a lower risk (AHR = 0.47, 0.28 and 0.17, respectively). With respect to stroke location, the risk of PSD in AP-treated patients was decreased regardless of location: brain stem (AHR = 0.41), diencephalon (AHR = 0.13), or multiple lesions (AHR = 0.40), the risk of PSD in AP-treated patients was decreased. For all baseline comorbidities, AP attenuated the risk of dysphagia. The cumulative incidence of dysphagia was remarkably lower in the AP group than in the non-AP group (log-rank test, P = 0.000).Limitations: First, this was a single-center clinical retrospective study. Second, we did not classify the severity of stroke and dysphagia. Third, all data were extracted manually. Lastly, the sample size was relatively small. Thus, future studies with larger sample sizes are warranted to verify our findings.Conclusion: Acupuncture treatment attenuates the risk of dysphagia in stroke patients. Future research should increase the sample size and elaborate further on the details of the AP protocol.

Abstract P291: Anger Expression and Risk of Stroke Subtypes: The Circulatory Risk in Communities Study (CIRCS)

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Tetsuya Ohira ◽  
Takeshi Tanigawa ◽  
Hironori Imano ◽  
Akihiko Kitamura ◽  
Masahiko Kiyama ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Hemorrhagic Stroke ◽  
Proportional Hazards Model ◽  
Statistical Significance ◽  
Anger Expression ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Adjusted Relative Risk ◽  
Stroke Subtypes ◽  
Increased Risk

Background: Previous studies have reported that anger expression style is associated with cardiovascular disease and its risk factors. Epidemiologic data regarding the association between anger expression and risk of stroke have been inconsistent, and few studies have reported the association of anger expression with stroke subtypes. Hypothesis: We assessed the hypothesis that suppressed anger is associated with increased risk of stroke, and the associations vary by stroke subtype. Methods: A prospective study of Japanese subjects aged 30–74 years was undertaken using data collected from 6,276 participants (2,285 men and 3,991 women) in cardiovascular risk surveys conducted in four communities between 1995 and 1998. We used the Spielberger Anger Expression Scale to measure self-reported levels of anger expression style; anger expressed outwardly is regarded as “anger-out” and anger held in or suppressed is classified as “anger-in.” The incidence of stroke was ascertained by systematic surveillance. The hazard ratios (HRs) of incidence of stroke and its subtypes and 95% confidence intervals (CI) relative to the lowest tertile of anger expression were calculated with adjustment for age and other potential confounding factors using the Cox proportional hazards model. Results: During an average follow up of 9.1-years, 129 incident strokes (50 hemorrhagic, 77 ischemic, and 2 unclassified strokes) occurred. Men with “anger-in” scores in the highest tertile had a 1.7-fold multivariable-adjusted relative risk of stroke as compared with those in the lowest tertile, but it did not reach statistical significance (HR; 1.73, 95% CI; 0.94–3.19, p=0.08). When stratifying for stroke subtypes, the associations between “anger-in” and stroke tended to be stronger for hemorrhagic stroke than ischemic stroke; HRs (95% CI) were 3.82 (1.03–14.1) for hemorrhagic stroke and 1.32 (0.64–2.71) for ischemic stroke. Anger-in score was not associated with incidence of either hemorrhagic or ischemic stroke in women. In men and women, there were no significant associations between “anger-out” and incidence of stroke. As compared with the lowest tertile of “anger-out” scores, the multivariable-adjusted HRs of stroke for the highest tertile of “anger-out” scores were 1.39 (0.74–2.59) for men and 1.48 (0.78–2.78) for women, respectively. Conclusions: Suppressed anger may be associated with increased risk of hemorrhagic stroke among middle-aged Japanese men, but not women.

Comparison of Valvulopathy Risk with Lorcaserin and Phenterminetopiramate for Weight Loss

2019 ◽  
Vol 14 (1) ◽  
pp. 74-78
Author(s):  
Michael Guo ◽  
Mahyar Etminan ◽  
Bruce Carleton
Keyword(s):  
Weight Loss ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Adverse Outcome ◽  
The United States ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Hazards Model ◽  
Hazard Ratios ◽  
One Year

Background: Lorcaserin and phentermine-topiramate are two drugs marketed for obesity that have shown moderate efficacy after one year of use. However, concerns over risks of serious cardiovascular harms including valvulopathy have been brought up for both drugs, prompting an epidemiologic investigation to quantify this adverse outcome using real-world clinical data. </P><P> Objective: To compare rates of valvulopathy between the weight-loss drugs lorcaserin and phentermine-topiramate. </P><P> Methods: A retrospective cohort study using the PharMetrics database from the United States was conducted. From approximately 9 million subjects captured in the database from 2006 to 2016, we identified all patients who had received at least one prescription for lorcaserin or phentermine-topiramate. Users of either drug were followed to the first mutually exclusive diagnosis of non-congenital valvulopathy defined as having received an international classification for diseases, ninth revision clinical modification [ICD-9- CM] code for valvulopathy, or to the end of the study period. A Cox Proportional Hazards model was then constructed to compute adjusted hazard ratios (HRs) to compare the rates of valvulopathy between users of the two drugs. </P><P> Results: We identified 1,981 lorcaserin users and 1,806 phentermine-topiramate users. Rates of valvulopathy for lorcaserin and phentermine-topiramate cohorts were 26 and 24 per 1000-person-years, respectively. The crude and adjusted hazard ratios (HRs) comparing the two cohorts with respect to valvulopathy were 1.28 (95% CI: 0.73,2.26) and 1.16 (95% CI: 0.65-2.05), respectively. </P><P> Conclusion: Our analysis suggests comparable rates of valvulopathy between lorcaserin and phentermine-topiramate users. Clinicians are advised to consider the risk of valvular disease when medically managing obesity.

Neither Size Nor Weight Predicts Survival in Peritoneal Dialysis Patients

1996 ◽  
Vol 16 (4) ◽  
pp. 357-361 ◽  
Author(s):  
Linda Fried ◽  
Judy Bernardini ◽  
Beth Piraino
Keyword(s):  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Patient Survival ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Dialysis Unit ◽  
Technique Survival ◽  
Hazards Model ◽  
Patient Size ◽  
One Year

Objective To determine if patient size or weight at the start of PO influences patient or technique survival. Design A prospective cohort study of adult PO patients. Setting A university and a Veterans Administration outpatient dialysis unit. Patients 343 adults patients with 660 years on PO enrolled from 1979 to 1995. Main Outcome Measures Patient survival (censoring for transplant, 60 days post -transfer to hemodialysis, and end of study) and technique survival (censoring for death, transplant, or end of the study) for patients as grouped by weight (≤ 64 kg vs. >64 kg or ≤82.7 kg vs. > 82.7 kg) or BSA (≤2.0 m2 vs >2.0 m2). Results Patient survival was 86.3% at one year, 77.0% at two years, 65.2% at three years, and 56.9% at 4 years. Technique survival was 84.9% at one year, 77.5% at two years, 63.5% at three years, and 58.3% at four years. The patient and technique survival curves were not significantly different for patients as grouped by weight or BSA. Using Cox proportional hazards model, age, diabetes, peritonitis rate, and albumin at the start of PO were independent predictors of patient survival, but BSA and weight were not. The only predictor of technique survival was the peritonitis rate. Larger patients had higher initial albumins, which may indicate better nutritional status that may offset the risk of underdialysis. Conclusions Large patients do as well as smaller patients on PO. Size alone should not preclude patients from PO.

Inverse association of mortality and BMI in patients with cardiomyopathy of any etiology

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Brazile ◽  
S Mulukutla ◽  
F Thoma ◽  
S Saba
Keyword(s):  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Obesity Paradox ◽  
Left Ventricular ◽  
Normal Weight ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Left Ventricular Ejection ◽  
Hazards Model ◽  
All Cause Mortality

Abstract Background Obesity is a worldwide epidemic that has been associated with poor outcomes. Previous studies have demonstrated an inverse relationship between body mass index (BMI) and patients' outcomes, the “obesity paradox”, in several diseases. Purpose We sought to evaluate whether the obesity paradox applies to cardiomyopathy patients of all etiologies, using all-cause mortality as the primary endpoint. Methods We conducted a retrospective study of cardiomyopathy patients (n=18,003) seen within the UPMC network between January 2011 and December 2017. Patients were divided into 4 BMI categories (underweight, normal weight, overweight, and obese) and stratified by left ventricular ejection fraction (LVEF): &lt;20%, 20–35%, and 36–50%. A Cox proportional hazards model was created to assess the independent predictive value of BMI on mortality. Results Over a median follow-up of 2.28 years, higher BMI was associated with better survival for the overall cohort (Figure) and within LVEF strata (p&lt;0.0001). The most common cause of hospitalization was subendocardial infarction among underweight and normal weight patients and heart failure among overweight and obese patients. Cox proportional hazards model showed that BMI, age, and comorbid conditions of COPD, CKD, and CAD are independent predictors of death. Conclusion Our results support the existence of an obesity paradox impacting all-cause mortality in cardiomyopathy patients of all etiologies even after adjusting for LVEF. Additional research is needed to understand the effect of weight loss on survival once a diagnosis of cardiomyopathy is established. Figure 1. Kaplan-Meier Survival Estimates Funding Acknowledgement Type of funding source: None

scholarly journals Hyperlipidemia is associated with lower risk of poststroke mortality independent of statin use: A population-based study

2016 ◽  
Vol 12 (2) ◽  
pp. 152-160 ◽  
Author(s):  
Samrat Yeramaneni ◽  
Dawn O Kleindorfer ◽  
Heidi Sucharew ◽  
Kathleen Alwell ◽  
Charles J Moomaw ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Statin Therapy ◽  
Survival Benefit ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards Model ◽  
Stroke Patients ◽  
Term Survival ◽  
Risk Of Mortality ◽  
Statin Use

Background Although statin therapy is associated with reduced stroke and mortality risk, some studies report that higher lipid levels are associated with improved outcomes following ischemic stroke. Aims We examined the association of hyperlipidemia (HLD) combined with statin therapy on all-cause mortality in stroke patients. Methods All stroke patients in the Greater Cincinnati Northern Kentucky region of ∼1.3 million were identified using ICD-9 discharge codes in 2005 and 2010. Stroke patients with and without HLD were categorized based on their reported statin use at baseline or discharge into three groups: no-HLD/no-statins, HLD/no-statins, and HLD/on-statins. Cox proportional hazards model was used to estimate the risk of mortality at 30 days, 1 year, and 3 years poststroke. Results Overall, 77% (2953) of the 3813 ischemic stroke patients were diagnosed with HLD and 72% ( n = 2123) of those patients were on statin medications. The mean age was 70.0 ± 14.6 years, 56% were women, and 21% were black. In adjusted analyses, the HLD/no-statins group showed 35% (adjusted hazard ratio (aHR) = 0.65, 95% CI: 0.46–0.92), 27% (aHR = 0.73, 95% CI: 0.59–0.90), and 17% (aHR = 0.83, 95% CI: 0.70–0.97) reduced risk of mortality at 30 days, 1 year, and 3 years, respectively, poststroke, compared with no-HLD/no-statins group. The HLD/on-statins group showed an additional 17% significant survival benefit at 3 years poststroke compared with HLD/no-statins group. Conclusions A diagnosis of HLD in ischemic stroke patients is associated with reduced short- and long-term mortality, irrespective of statin use. Statin therapy is associated with significant, additional long-term survival benefit.

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