Exploring the Link between Fasting Triglyceride Levels and Stroke Infarct Volume
Surabhi Garg1, Tuqa Asedi2, Elyse Vetter2, Hussein Alsadi3, Rachel Dukes3, Chelsey Schartz2, Mohammed Qussay Ali Al-Sabbagh3, Sibi Thirunavukkarasu4, Prasanna Venkatesan Eswaradass5
1Medicine, The Ottawa Hospital, University of Ottawa, 2University of Kansas School of Medicine, 3University of Kansas Medical Center, 4Neurology, University of Alberta, 5University of Kansas Health System
Objective:

To analyze the association between fasting triglyceride levels and Computed Tomography Perfusion (CTP) infarct volume in acute ischemic stroke (AIS).

Background:

Larger infarct volume is known to be predictive of poor stroke outcomes. While some studies suggest a correlation between elevated triglycerides and increased stroke risk, others propose a protective role of triglycerides during acute stroke in terms of severity and three months outcomes. However, the effect of fasting triglyceride levels on infarct volume is not well established.

Design/Methods:

We did a retrospective analysis of AIS patients admitted to a tertiary care United States center from 2010 to 2023. Inclusion criteria were AIS patients who within 24 hours of onset (1) underwent CTP and (2) had fasting triglyceride levels measured. Infarct volume was calculated using RAPID software (iSchemaView, Inc.) Statistical analyses were conducted using STATA (Release 16), with T-tests, ANOVA, chi-square tests, and multivariable linear regression applied as appropriate.

Results:
We included 178 patients, 52% (n = 92) of whom were male, with mean age of 67±4.0 years. Mean triglyceride levels were 116.91 ± 70.23 mg/dL, and mean infarct volume was 41.64 ± 53.35 mL. Linear regression showed that triglyceride levels and infarct volume had a significant positive correlation (p < 0.01, β = 0.17, 95% CI: 0.06–0.28). There was a 0.17 mL increase in infarct volume per unit increase in triglyceride levels. Embolic stroke of undetermined source (ESUS) patients had the highest mean triglyceride levels (135.61 mg/dL) and larger infarct volumes compared to those with large artery atherosclerosis (p < 0.05).
Conclusions:

We found that hypertriglyceridemia positively correlated with larger infarct volumes, especially in ESUS patients. Our study raises an important question as to whether triglycerides need to be targeted for stroke prevention along with Low Density Lipoproteins (LDL) and glycated hemoglobin (A1C). Future studies are needed to further investigate this potential link.

10.1212/WNL.0000000000208399
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