Vol 15, Issue 2, 2022 Online - 2455-3891 Print - 0974-2441 TO STUDY THE SERUM LIPID PROFILE IN ISCHEMIC AND HEMORRHAGIC STROKE AMONG THE PATIENTS IN TERTIARY HEALTH CENTRE ANKUR CHHARI 1 *, KHANNA V N 1 , RAHUL JAIN 1 , VISHNU PAL 2 1 Department of Medicine, PCMS and RC, Bhopal, Madhya Pradesh, India. 2 Department of Anatomy, PCMS and RC, Bhopal, Madhya Pradesh, India. E-mail: dr.ankur85@gmail.com Received: 01 December 2021, Revised and Accepted: 15 January 2021 ABSTRACT Objectives: To assess, correlate and compare the levels of various parameters of lipid profile in patients with ischemic and hemorrhagic stroke. Methods: The study was conducted as an observational study at the Department of Medicine, People’s Hospital on 100 patients presenting with focal neurological deficit, altered sensorium, or with CT/MRI findings suggestive of stroke during the study duration of 18 months. Based upon the type of stroke, patients were categorized into two groups, i.e. ischemic stroke and hemorrhagic stroke. NCEP-ATP III guidelines were used for estimation of dyslipidemia and association of dyslipidemia was observed with type of stroke. Results: Of 100 cases, ischemic stroke was documented in 74% cases, whereas 26% of patients presented with hemorrhagic stroke. Two groups were comparable in terms of baseline characteristics (p>0.05). Mean total cholesterol levels and total cholesterol and total cholesterol to HDL ratio was significantly higher in ischemic stroke as compared to hemorrhagic stroke (p<0.05). However, mean serum HDL level was significantly lower in patients with ischemic stroke as compared to hemorrhagic stroke (p<0.05). Total cholesterol, and total cholesterol: HDL ratio showed statistically significantly negative correlation with type of stroke and positive correlation was noted between HDL and hemorrhagic stroke. Conclusion: The prevalence of stroke is rising rapidly and the age of presentation of stroke is reducing. Ischemic stroke is the most common type of stroke whereas hemorrhagic stroke is less commonly observed in less than one-third of patients. Dyslipidemia is a significant risk factor for ischemic stroke. Raised Total cholesterol, and total cholesterol: HDL levels and lower HDL levels are independent predictors of ischemic stroke. Keywords: Stroke, Dyslipidemia, Correlation, Total cholesterol: HDL ratio. INTRODUCTION Stroke also called cerebrovascular accident or brain attack is characterized by neurological deficit which is due to acute focal injury to the central nervous system [1]. According to the Global stroke factsheet, new cases of stroke are reported in 13.7 million individuals each year. Every fourth individual over the age of 25 years is expected to experience a stroke in their lifetime. Incidence of stroke increase with age and more than 60% of strokes are reported in the age group of more than 70 years. Men and women are equally affected [2]. Various risk factors predispose to the development of stroke which includes increasing age, male gender, family history, ethnicity, genetic factors, lifestyle factors (such as smoking, alcohol), low socioeconomic status, diabetes, hypertension, heart disease, hypercholesterolemia, and obesity [3]. Atherosclerosis is considered as most common underlying pathology in stroke which leads to the formation of atherothrombotic plaque. Changes in lipid profile are considered as important risk factors in the occurrence of stroke. However, it has been documented that in patients with stroke, serum lipid levels are affected as a result of accompanying stress and increased production of catecholamines [4]. Deranged serum lipid levels in stroke have been associated with significant mortality. Literature suggests an inverse relationship between total cholesterol levels and mortality in patients with hemorrhagic stroke, whereas raised serum cholesterol has been documented in ischemic stroke [5]. It is important to assess the levels of lipids in patients with various types of stroke so as to appropriately guide the lipid-lowering therapy. The lipid-lowering drugs may help in reducing the morbidity as well as mortality associated with stroke by adapting primary and secondary preventive measures [6,7]. The present study was conducted at tertiary care center to assess, correlate and compare the levels of various parameters of lipid profile in patients with ischemic and hemorrhagic stroke. METHODS The study was conducted as an observational study at the Department of Medicine, People’s College of Medical Sciences and People’s Hospital on 100 patients presenting with focal neurological deficit, altered sensorium, and with CT/MRI findings suggestive of stroke during the study period of December 01, 2018 to May 31, 2020 (18 months). All the patients above 14yrs across both the genders presenting with focal neurological deficit, altered sensorium, and CT/MRI findings consistent with ischemic or hemorrhagic stroke were included in the study whereas patients under the age of 14 years; on lipid-lowering agents; with a past history of stroke, stroke secondary to trauma, demyelination disorders, transient ischemic attack or patients with any neurological deficit due to meningitis and encephalitis and due to other infective etiologies were excluded from the study. After obtaining ethical clearance from Institute’s ethical committee, all the patients fulfilling inclusion criteria and giving written consent were enrolled. Detailed history regarding sociodemographic variables such as age, gender, socioeconomic status was obtained and entered in questionnaire. Detailed history regarding presenting complaints, duration of symptoms, presence of comorbidities, addiction, diet, and comorbid conditions were enquired and noted. Further, all the patients were subjected to detailed general and systemic examination including neurological examination. Venous samples were obtained under strict aseptic precautions and subjected to CBC, lipid profile, and blood glucose estimation using standard protocol. National Cholesterol Education Program-Adult Treatment Panel III (NCEP- ATP III) guidelines [8] were used for the estimation of dyslipidemia. Further, all the patients were subjected to neuroimaging study with either CT scan or MRI. © 2022 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (http://creativecommons.org/ licenses/by/4.0/) DOI: http://dx.doi.org/10.22159/ajpcr.2022v15i2.43732. Journal homepage: https://innovareacademics.in/journals/index.php/ajpcr Research Article