Background and Purpose: Modification of low-density lipoprotein cholesterol (LDL-C) has been proved to be an essential component in the primary and secondary prevention of stroke. However, limited data are available on LDL-C goal achievement in patients with ischemic stroke in China. The aim of this study was to assess the management of low-density lipoprotein cholesterol (LDL-C) in patients suffering from ischemic stroke within 6-12 months and to explore the predictors of the achievement of LDL-C target.
Method: This study was a nation-wide, multicenter, cross-sectional study conducted from July 2013 to August 2013. Patients who had an ischemic stroke within 6-12 months and were more than 18-year old were included into this study. All data referred to personal information, medical history, medication and laboratory tests were collected by face-to-face questionnaires, physical examination and blood tests. The predictors for the achievement of LDL-C target (<1.8mmol/l or <70mg/dl) were analyzed by the multivariate analysis.
Results: In this study, a total of 3956 cases from 56 centers suffered from ischemic stroke within 6-12 months were finally included into this study. The average serum level of LDL-C in all these patients was 2.42 ± 0.91mmol/l with the median of 2.30 mmol/l and the total LDL-C goal achievement rate is 27.35% (95% CI: 25.97%-28.77%). Lipid-lowering therapy (Odds Ratio [OR]=3.045, 95%CI: 2.456-3.810) was the most significant predictor for LDL-C target achievement and female (OR=0.684, 95% CI: 0.540-0.867), current smoking (OR=0.627, 95% CI: 0.480-0.817), and history of dyslipidemia (OR=0.592, 95% CI: 0.497-0.704) were three other important factors for the LDL-C goal achievement.
Conclusions: Although the lipid modulation in stroke patients is recommended by the international guidelines, the goal achievement of LDL-C was still very low in this population in China. The modifiable predictors including the use of lipid-lowering drugs and smoking cessation should be improved in dyslipidemia management.