NEW YORK (Reuters Health) – Elevated nonfasting levels of triglycerides, a marker for remnant lipoproteins, are associated with an increased risk of ischemic stroke, according to analysis of data from the Copenhagen City Heart Study (CCHS).

“The role of triglycerides in the risk of ischemic stroke remains controversial,” Dr. Borge G. Nordestgaard and colleagues write in the November 12th issue of the Journal of the American Medical Association.

However, they explain, most studies examining this topic have focused only on fasting triglyceride levels. The possibility of a link with nonfasting triglyceride levels is supported by two recent studies showing a direct relationship between these levels and the risks of MI, ischemic heart disease, and death.

To determine if a similar association might also exist with stroke, Dr. Nordestgaard, from Copenhagen University Hospital, and co-researchers analyzed data from 13,956 CCHS participants who were followed from 1976 to July 2007.

During follow-up, 1529 subjects sustained an ischemic stroke. The cumulative incidence of stroke was directly related to the nonfasting triglyceride level (p < 0.001). Compared with men who had nonfasting triglyceride levels below 89 mg/dL, those with levels of 443 mg/dL or greater were 2.5-times more likely to develop an ischemic stroke. In women, a corresponding 3.8-fold increased risk was seen. The absolute risk of stroke at 10 years ranged from 2.6% in men younger than 55 years of age with nonfasting triglyceride levels below 89 mg/dL to 16.7% for men older than 54 years with levels of 443 mg/dL or higher. The corresponding risks in women were 1.9% and 12.2%. A separate cross-sectional analysis was performed on 9637 subjects who attended the 1991-1994 examination of CCHS. This showed that median nonfasting triglyceride levels were significantly higher in stroke patients than in non-stroke patients (men, 191 vs. 148 mg/dL, women, 167 vs. 127 mg/dL). Remnant cholesterol levels were also significantly greater in stroke patients. “Our results, together with these from 2 previous studies, suggest that elevated levels of nonfasting triglycerides and remnant lipoprotein cholesterol could be considered together with elevated levels of LDL cholesterol for prediction of cardiovascular risk. However, these findings require replication in other populations.” Reference:
JAMA 2008;300:2142-2152.