TRIGLYCERIDES: A powerful second stroke marker

TRIGLYCERIDES: A powerful second stroke marker

Stroke can have many causes. An atherothrombotic stroke is caused by a clot that forms from plaques that build up in the blood vessels of the brain. This study suggests that people who have this type of stroke and also have higher blood levels of triglycerides, have a higher risk of another stroke or other cardiovascular problems in the following year, compared to patients who have also had a stroke but have lower triglyceride levels.

Triglycerides contribute to arterial stiffness

Statins, only part of the therapy: therefore, high levels of triglycerides are associated with an increased risk of heart attack, heart disease and stroke, Japanese researchers point out. The study suggests that after an atherothrombotic stroke, having high levels of triglycerides in the blood is a risk factor for a new stroke even with statins. Lead author Dr. Takao Hoshino of Tokyo Women’s Medical University comments on these new data by considering statins only as “one of several treatments to manage high triglyceride levels”. “Diet and exercise are also effective ways to lower blood triglyceride levels.”

The study is conducted among 870 participants, aged 70 on average, who have suffered a stroke or transient ischemic attack. 25% of participants had elevated triglyceride levels, defined as fasting triglyceride levels >150 milligrams per dL. Participants were followed for 1 year. After adjusting for various possible confounding factors, including cholesterol levels and statin use, the analysis reveals that:

  • high triglyceride levels are associated with a 21% increased risk of death, stroke or heart disease at 1 year vs a 10% higher risk in participants with lower triglyceride levels;
  • participants with a second stroke after a first atherothrombotic stroke represent 16% of participants with high blood triglyceride levels vs. 12% of participants with normal blood triglyceride levels; this confirms a higher risk of a second stroke in people with high triglyceride levels;
  • for acute coronary syndrome, 0.9% of participants with normal triglyceride levels developed heart disease one year after an atherothrombotic stroke, vs. 8% of participants with high triglyceride levels; this confirms a higher risk of heart disease in people with high triglycerides;
  • no association is found between higher levels of triglycerides and future cardiovascular problems in people who have suffered another type of first “cardioembolic” stroke.

In summary, “triglyceride levels thus appear as a possible target for the prevention of future strokes

and other cardiovascular problems, especially in people who have suffered a first stroke of the atherothrombotic type. While statin therapy is still effective for people with high triglycerides, it is still necessary to take into account the full arsenal of triglyceride-lowering tools, including the adoption of a balanced diet, the practice exercise as well as the intake of omega-3 fatty acids”.

However, the study does not show that lowering high triglyceride levels can prevent people who have had a first atherothrombotic stroke from developing cardiovascular problems later in life. But monitoring is necessary…

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