[Lipid profile in the hyperacute phase of ischemic stroke allows to decide cholesterol-lowering therapy]. / Inicio del tratamiento hipolipemiante en función del perfil lipídico en la fase hiperaguda del ictus.

BACKGROUND AND OBJECTIVE: We aimed to determine whether measuring the hyperacute lipid profile helps to start a cholesterol-lowering therapy soon after an ischemic stroke. PATIENTS AND METHOD: 72 ischemic stroke patients underwent lipid determinations at three times (hyperacute phase or arrival, second day and the third month). RESULTS: Total cholesterol, cLDL, cHDL and triglyceride mean values were significantly higher (p < 0.05) at arrival compared to the second day (212 vs 189; 131 vs 120; 52 vs 44 and 132 vs 115, respectively). In the third month, mean values were similar to those of the hyperacute phase (197, 131, 48 and 143, respectively). Considering the updated cholesterol management guidelines, we should treat 55% of patients diagnosed at the hyperacute phase but only 37% of patients diagnosed at the second day. CONCLUSION: Hyperacute lipid profile determination helps to determine those patients who need a cholesterol-lowering therapy without delay.

Inicio del tratamiento hipolipemiante en función del perfil lipídico en la fase hiperaguda del ictus / Lipid profile in the hyperacute fase of ischemic stroke allows to decide cholesterol-lowering therapy

FUNDAMENTO Y OBJETIVO: Valorar si la determinación del perfil lipídico permite evitar las modificaciones de la fase aguda y tomar la decisión de iniciar un tratamiento hipolipemiante al alta. PACIENTES Y MÉTODO: Se realizaron determinaciones seriadas de lípidos en 72 pacientes afectados de ictus isquémicos consecutivos a sullegada (tiempo medio entre el inicio de los síntomas y la determinación de 6,3 h), al ingreso(tiempo medio de 48 h) y al tercer mes. RESULTADOS: Los valores medios de colesterol total (CT), colesterol ligado a lipoproteínas de baja densidad (cLDL), colesterol ligado a lipoproteínas de alta densidad (cHDL) y triglicéridos(TG) fueron significativamente superiores(p < 0,05) en fase hiperaguda respecto del ingreso(212 frente a 189; 131 frente a 120;52 frente a 44 y 132 frente a 115). Al tercer mes, los valores fueron similares a los de la fase hiperaguda (197, 131, 48 y 143, respectivamente).Si se consideran los nuevos límites para iniciar tratamiento, lo requerirían un 55%de pacientes cuya determinación se realiza en fase hiperaguda frente a sólo un 37% al considerarlos valores del ingreso. CONCLUSIÓN: La determinación aguda del perfillipídico permite detectar con precisión a los pacientes que requieren un tratamiento hipolipemiante y comenzarlo sin demoras innecesarias

BACKGROUNG AND OBJECTIVE: We aimed to determine whether measuring the hyperacute lipid profile helps to start a cholesterollowering therapy soon after an ischemic stroke. PATIENTS AND METHOD: 72 ischemic stroke patients underwent lipid determinations at three times (hyperacute phase or arrival, second dayand the third month). RESULTS: Total cholesterol, cLDL, cHDL and triglyceride mean values were significantly higher (p < 0.05) at arrival compared to the second day (212 vs 189; 131 vs 120; 52 vs44 and 132 vs 115, respectively). In the third month, mean values were similar to those of the hyperacute phase (197, 131, 48 and 143,respectively). Considering the updated cholesterolman agement guidelines, we should treat55% of patients diagnosed at the hyperacutephase but only 37% of patients diagnosed at the second day. CONCLUSION: Hyperacute lipid profile determination helps to determine those patients who need a cholesterol lowering therapy without delay