An elevated serum lipid level has been a well-documented risk factor for coronary artery disease (CAD). Recently, there has been an increased focus on examining the relationship between elevated lipid levels and the incidence of stroke. In particular, some recent clinical trials have analyzed the association between lipids and non-hemorrhagic stroke. The reduction of LDL cholesterol, through lifestyle modification and drug therapy, for the prevention of strokes and other vascular events is recommended for patients with CAD in the National Cholesterol Education Program Adult Treatment Panel III (NCEPATPIII) Guidelines. In addition, recent evidence from the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial supports the use of statins to lower LDL cholesterol in stroke patients without prior CAD and a fasting LDL > 100 mg/dL.

Based on these guidelines, all patients with ischemic stroke should have lipid profile measurement performed within 48 hours of admission unless outpatient results are available from within the past 30 days. Treatment for secondary prevention should be initiated in patients who meet NCEP ATPIII criteria in the presence of LDL> 100 mg/dL, or continued for patients who were previously on lipid-lowering therapy an have an LDL< 100 mg/dL.

• American Academy of Neurology
• The Official Journal of the American Academy of Neurology
• National Institute of Neurological Disorders and Stroke

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• Feinberg WM, Albers GW, Barnett HJM, et al. Guidelines for the Management of Transient Ischemic Attacks. From the Ad Hoc Committee on Guidelines for the Management of Transient Ischemic Attacks of the Stroke Council if the American Heart Association. 1994.
• National Institutes of Health. Third Report of the National Cholesterol Education Program(NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Final Report. National Cholesterol Education Program National Heart, Ling, and Blood Institute National Institutes of Health. NIH Publication No. 12-5215. 2002.4 - 27.
• Ralph L. Sacco, Robert Adams, Greg Albers, Mark J. Alberts, Oscar Benavente; Karen Furie, Larry B. Goldstein, Philip Gorelick, Jonathan Halperin, Robert Harbaugh, S. Claiborne Johnston, Irene Katzan, Margaret Kelly-Hayes, Edgar J. Kenton, Michael Marks, Lee H. Schwamm, Thomas Tomsick. Guidelines for Prevention of Stroke in Patients With Ischemic Stroke or Transient Ischemic Attack: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association Council on Stroke: Co-Sponsored by the Council on Cardiovascular Radiology and Intervention. Stroke Vol. 37, 2006:577.

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