LDL-C target-goal achievements in patients with acute and old cerebral infarction: a retrospective study

Abstract Objective To investigate the baseline and six-month follow-up data of main lipid indexes and LDL-C target goal attainment regarding current guidelines among patients with acute and old cerebral infarction (ACI, OCI). Method A total of 1099 patients hospitalized in the Department of Neurology from January 2021 to December 2022 were consecutively enrolled and divided into ACI, OCI and control groups. General data (sex, age, body mass index (BMI), medications, smoking and disease history, etc. ), baseline and six-month follow-up laboratory data were collected and analyzed. Patients with ACI were divided into dyslipidemia and normal groups according to the lipid management guidelines of the European, American and Chinese populations. The chi-square test, Mann‒Whitney U test and logistic regression were used to screen possible predictors for dyslipidemia. Result TC and LDL-C levels among patients with ACI or OCI were significantly higher than those in the control group (all P < 0.05). Whether according to European (94.7% vs 89.0% vs 13.4%, P = 0.003), American (94.7% vs 67.7%% vs 45.9%, P < 0.001) or Chinese (85.1% vs 59.1% vs 18.6%, P < 0.001) standards, the proportion of dyslipidemia in patients with ACI was higher than that in patients with OCI and the control group. According to European and American standards, elevated BMI and eGFR were predictors for dyslipidemia in ACI patients. According to Chinese standards, elevated BMI, HbA1c and eGFR were independent predictors for dyslipidemia. The 6-month follow-up of the main lipid levels showed that among patients with ACI, the levels of TC, LDL-C, and TGs (4.86 vs 3.79, P < 0.001; 2.98 vs 2.01, P < 0.001; 1.46 vs 1.20, P < 0.001) and the proportion of dyslipidemia decreased significantly by European/American or Chinese standards (86.8% vs 64.6%, P = 0.015; 97.2% vs 84.7%, P = 0.012). Conclusion This study showed that lipid management was still not optimistic in patients with ACI. More attention should be given to patients with elevated BMI, eGFR and HbA1c. Although the main lipid levels decreased significantly 6 months after discharge with lipid-lowering therapy, there was still a long way to go to enable more patients to achieve the guideline-recommended lipid target goal.