TY - JOUR
T1 - Plasma lipids predict myocardial infarction, but not stroke, in patients with established cerebrovascular disease
AU - Patel, Anushka
AU - Woodward, Mark
AU - Campbell, Duncan J.
AU - Sullivan, David R.
AU - Colman, Samuel
AU - Chalmers, John
AU - Neal, Bruce
AU - MacMahon, Stephen
PY - 2005/9
Y1 - 2005/9
N2 - Aims: To evaluate the role of plasma lipids in recurrent vascular events, including stroke, among individuals with established cerebrovascular disease. Methods and results: Plasma total cholesterol, HDL cholesterol, and triglycerides were measured at baseline among individuals participating in the Perindopril Protection Against Recurrent Stroke (PROGRESS) study, a randomized clinical trial of blood pressure lowering among patients with previous stroke or transient ischaemic attack. A series of nested case-control studies were used to investigate the association between each of these lipid variables and the risk of subsequent haemorrhagic stroke, ischaemic stroke, myocardial infarction (MI), and heart failure. A total of 895 patients were selected as cases (83 haemorrhagic stroke, 472 ischaemic stroke, 206 MI, and 258 heart failure) and each was matched with one to three controls. After adjustment for other major cardiovascular risk factors, none of the lipid variables was associated with the risk of either stroke subtype. There were significant positive and negative associations for total cholesterol and HDL, respectively, with the risk of MI; the odds ratio comparing the highest and lowest thirds of each of these lipid variables was 2.00 (95% CI: 1.30-3.09) for total cholesterol and 0.58 (95% CI: 0.37-0.90) for HDL. HDL was inversely associated with the risk of heart failure; however, this result was of borderline statistical significance (P = 0.05). Conclusion: Lipid variables are associated with the risk of MI, but not recurrent stroke, in patients with established cerebrovascular disease.
AB - Aims: To evaluate the role of plasma lipids in recurrent vascular events, including stroke, among individuals with established cerebrovascular disease. Methods and results: Plasma total cholesterol, HDL cholesterol, and triglycerides were measured at baseline among individuals participating in the Perindopril Protection Against Recurrent Stroke (PROGRESS) study, a randomized clinical trial of blood pressure lowering among patients with previous stroke or transient ischaemic attack. A series of nested case-control studies were used to investigate the association between each of these lipid variables and the risk of subsequent haemorrhagic stroke, ischaemic stroke, myocardial infarction (MI), and heart failure. A total of 895 patients were selected as cases (83 haemorrhagic stroke, 472 ischaemic stroke, 206 MI, and 258 heart failure) and each was matched with one to three controls. After adjustment for other major cardiovascular risk factors, none of the lipid variables was associated with the risk of either stroke subtype. There were significant positive and negative associations for total cholesterol and HDL, respectively, with the risk of MI; the odds ratio comparing the highest and lowest thirds of each of these lipid variables was 2.00 (95% CI: 1.30-3.09) for total cholesterol and 0.58 (95% CI: 0.37-0.90) for HDL. HDL was inversely associated with the risk of heart failure; however, this result was of borderline statistical significance (P = 0.05). Conclusion: Lipid variables are associated with the risk of MI, but not recurrent stroke, in patients with established cerebrovascular disease.
KW - Haemorrhagic stroke
KW - Heart failure
KW - Ischaemic stroke
KW - Myocardial infarction
KW - Nested case-control study
UR - http://www.scopus.com/inward/record.url?scp=24344499120&partnerID=8YFLogxK
U2 - 10.1093/eurheartj/ehi407
DO - 10.1093/eurheartj/ehi407
M3 - Article
C2 - 16006443
AN - SCOPUS:24344499120
SN - 0195-668X
VL - 26
SP - 1910
EP - 1915
JO - European Heart journal
JF - European Heart journal
IS - 18
ER -
