Evaluating the utility of fasting lipid panel in addition to random lipid panel in determining lipid-lowering therapy in acute ischemic stroke or TIA patients

• Published in: Clinical neurology and neurosurgery 2020-10, Vol.197, p.106068-106068, Article 106068
• Main Authors: Shehzad, Usman, Tumati, Abhinay, Reinsel, Ruth A., Singh, Dharampreet, Dadra, Dazzle, Purushotham, Archana, Mathew, Jason
• Format: Article
• Language: English
• Subjects: Acute ischemic stroke; Cardiology; Cerebrovascular diseases; Cholesterol; Disease prevention; Fasting; Fasting LDL; Hyperlipidemia; Ischemia; Lipids; Low density lipoprotein; Management; Neurology; Patients; Random LDL; Risk factors; Statins; Stroke; Transient ischemic attack
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2020.106068

•We compared both random and fasting LDL levels in 206 patients with diagnosis of AIS or TIA on admission.•Foregoing a fasting lipid panel to guide LLT in patients with AIS or TIA is appropriate in most cases.•For patients with random LDL levels 70 to 99, fasting lipid profile should be obtained prior to deciding upon LLT.•We present a decision algorithm to guide lipid management in acute stroke patients. Hyperlipidemia is one of the major risk factors for cerebrovascular disease and it is common practice to obtain fasting lipid profile prior to starting lipid lowering therapy (LLT). Recent AHA Guidelines published in 2018 allow for a non-fasting value to be used. To determine if obtaining fasting lipid levels in addition to random lipid levels prompts changes in hyperlipidemia management of acute stroke patients. 206 patients met the study criteria which included a diagnosis of acute ischemic stroke or transient ischemic attack on admission and availability of both random and fasting LDL levels collected within 72 h of each other. Patients were divided into three groups based on random LDL at admission: Group A: LDL