Abstract 2645: Functional Outcome in Young Adults after First-Ever Ischemic Stroke: A Particular Impact of Lipoproteins
Background and Purpose: We aimed to determine functional outcome in a cohort of young adults with ischemic stroke, focusing on components of lipid profile.
Methods: In our registry including consecutive patients with first-ever ischemic stroke aged 15 to 49 from 1994-2007, we analyzed predictors of 3-month functional outcome (modified Rankin Scale, mRS). Infarct size fell into small, medium, large posterior, or large anterior. Stroke severity was assessed with NIH Stroke Scale (NIHSS). Serum lipids were measured within 72 h after admission. Binary, multinomial ordinal, and Poisson regressions allowed revealing factors associated with size of infarct, stroke severity, and unfavorable outcome or death (mRS, 2-6) or mRS as an ordinal measure.
Results: In the 968 patients included (mean age 41.3±7.6; 62.6% males; 49.5% with mRS 0-1), factors associated with unfavorable outcome after multivariable analysis were increasing age (odds ratio 1.03 per year, 95% confidence interval 1.01-1.05), higher NIHSS score (1.22 per point, 1.16-1.29), large anterior infarcts (4.51, 2.22-9.17), bilateral lesions (2.61, 1.43-4.77), internal carotid artery dissection (ICAD) (3.45, 1.29-9.19), large-artery atherosclerosis (2.30, 1.03-5.11), and inversely high-density lipoprotein (HDL) levels (0.59 per unit increase, 0.39-0.89). Increasing HDL associated with smaller infarct size (0.70, 0.49-0.98) and higher levels of HDL and low-density lipoprotein (LDL) were both associated with a lower NIHSS score (0.81, 0.75-0.88 for HDL; 0.96, 0.93-0.99 for LDL) and lower 3-month mRS (0.65, 0.47-0.90 for HDL; 0.86, 075-0.98 for LDL).
Conclusions: In addition to known prognosticators, ICAD and lower HDL levels were independently associated with adverse clinical outcomes in our young adult stroke cohort.
- © 2012 by American Heart Association, Inc.