Suboptimal lipid management before and after ischaemic stroke and TIA—the North Dublin Population Stroke Study

• Published in: Irish journal of medical science 2018-08, Vol.187 (3), p.739-746
• Main Authors: Ní Chróinín, Danielle, Ní Chróinín, Chantelle, Akijian, Layan, Callaly, Elizabeth L., Hannon, Niamh, Kelly, Lisa, Marnane, Michael, Merwick, Áine, Sheehan, Órla, Horgan, Gillian, Duggan, Joseph, Kyne, Lorraine, Dolan, Eamon, Murphy, Seán, Williams, David, Kelly, Peter J.
• Format: Article
• Language: English
• Subjects: Family Medicine; General Practice; Internal Medicine; Medicine; Medicine & Public Health; Original Article
• ISSN: 0021-1265; 1863-4362
• DOI: 10.1007/s11845-018-1739-8

Background Few population-based studies have assessed lipid adherence to international guidelines for primary and secondary prevention in stroke/transient ischaemic attack (TIA) patients. Aims This study aims to evaluate adherence to lipid-lowering therapy (LLT) guidelines amongst patients with ischaemic stroke/TIA. Methods Using hot and cold pursuit methods from multiple hospital/community sources, all stroke and TIA cases in North Dublin City were prospectively ascertained over a 1-year period. Adherence to National Cholesterol Education Programme (NCEP) III guidelines, before and after index ischaemic stroke/TIA, was assessed. Results Amongst 616 patients (428 ischaemic stroke, 188 TIA), total cholesterol was measured following the qualifying event in 76.5% (471/616) and low-density lipoprotein (LDL) in 60.1% (370/616). At initial stroke/TIA presentation, 54.1% (200/370) met NCEP III LDL goals. Compliance was associated with prior stroke (odds ratio [OR] 2.19, p  = 0.02), diabetes (OR 1.91, p  = 0.04), hypertension (OR 1.57, p  = 0.03), atrial fibrillation (OR 1.78, p  = 0.01), pre-event LLT (OR 2.85, p