Lower levels of high-density lipoprotein cholesterol on admission and a recurrence of ischemic stroke: a 12-month follow-up of the Fukuoka Stroke Registry.

Background: Despite recent progress in treatments for secondary prevention, ischemic stroke recurs in 8% to 12% of stroke survivors. We investigated the predisposing factors associated with recurrence within the first 12 months after an ischemic event to explore more effective preventive strategies.

Methods: Between June 2007 and April 2008, acute (within 7 days of onset) ischemic stroke patients were registered in the Fukuoka Stroke Registry (FSR), a multicenter, prospective, observational database. The clinical characteristics on admission were analyzed, and the patients were followed for 12 months.

Results: Two hundred sixty patients (151 males and 109 females, 71 ± 11 years of age) were registered; 25 (9.6%) had recurrence of ischemic stroke during the follow-up period. Kaplan-Meier curve analysis revealed a significant difference in recurrence-free survival between patients with high-density lipoprotein (HDL) cholesterol <40 mg/dL on admission and those with HDL cholesterol ≥ 40 mg/dL (P = .042). Adjusted multivariate logistic regression analysis showed that age (odds ratio 1.06; 95% CI, 1.00-1.11; P = .035) and HDL cholesterol <40 mg/dL (odds ratio 2.73; 95% CI, 1.01-7.38; P = .048) on admission were independently associated with a recurrence of ischemic stroke within 12 months of the initial onset.

Conclusions: Aging and low HDL cholesterol levels are considered independent risk factors for a recurrence of ischemic stroke.