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April 01, 2014; 82 (13) Article

High free fatty acid level is associated with recurrent stroke in cardioembolic stroke patients

Jeong-Yoon Choi, Ji-Sun Kim, Ji Hyun Kim, Kyungmi Oh, Seong-Beom Koh, Woo-Keun Seo
First published February 28, 2014, DOI: https://doi.org/10.1212/WNL.0000000000000264
Jeong-Yoon Choi
From the Department of Neurology (J.-Y.C.), Korea University College of Medicine, Korea University Ansan Hospital, Ansan; Department of Neurology (J.-S.K.), Korea University College of Medicine, Korea University Anam Hospital, Seoul; and Department of Neurology (J.H., K.O., S.-B.K., W.-K.S.), Korea University College of Medicine, Korea University Guro Hospital, Seoul.
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Ji-Sun Kim
From the Department of Neurology (J.-Y.C.), Korea University College of Medicine, Korea University Ansan Hospital, Ansan; Department of Neurology (J.-S.K.), Korea University College of Medicine, Korea University Anam Hospital, Seoul; and Department of Neurology (J.H., K.O., S.-B.K., W.-K.S.), Korea University College of Medicine, Korea University Guro Hospital, Seoul.
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Ji Hyun Kim
From the Department of Neurology (J.-Y.C.), Korea University College of Medicine, Korea University Ansan Hospital, Ansan; Department of Neurology (J.-S.K.), Korea University College of Medicine, Korea University Anam Hospital, Seoul; and Department of Neurology (J.H., K.O., S.-B.K., W.-K.S.), Korea University College of Medicine, Korea University Guro Hospital, Seoul.
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Kyungmi Oh
From the Department of Neurology (J.-Y.C.), Korea University College of Medicine, Korea University Ansan Hospital, Ansan; Department of Neurology (J.-S.K.), Korea University College of Medicine, Korea University Anam Hospital, Seoul; and Department of Neurology (J.H., K.O., S.-B.K., W.-K.S.), Korea University College of Medicine, Korea University Guro Hospital, Seoul.
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Seong-Beom Koh
From the Department of Neurology (J.-Y.C.), Korea University College of Medicine, Korea University Ansan Hospital, Ansan; Department of Neurology (J.-S.K.), Korea University College of Medicine, Korea University Anam Hospital, Seoul; and Department of Neurology (J.H., K.O., S.-B.K., W.-K.S.), Korea University College of Medicine, Korea University Guro Hospital, Seoul.
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Woo-Keun Seo
From the Department of Neurology (J.-Y.C.), Korea University College of Medicine, Korea University Ansan Hospital, Ansan; Department of Neurology (J.-S.K.), Korea University College of Medicine, Korea University Anam Hospital, Seoul; and Department of Neurology (J.H., K.O., S.-B.K., W.-K.S.), Korea University College of Medicine, Korea University Guro Hospital, Seoul.
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Citation
High free fatty acid level is associated with recurrent stroke in cardioembolic stroke patients
Jeong-Yoon Choi, Ji-Sun Kim, Ji Hyun Kim, Kyungmi Oh, Seong-Beom Koh, Woo-Keun Seo
Neurology Apr 2014, 82 (13) 1142-1148; DOI: 10.1212/WNL.0000000000000264

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Abstract

Objective: To determine whether the plasma level of free fatty acid (FFA) could be associated with recurrent stroke in cardioembolic (CE) stroke patients.

Methods: We analyzed data from 669 acute ischemic stroke patients and examined the association between FFA concentration and recurrent stroke in CE stroke patients compared with non-CE stroke patients.

Results: The baseline plasma FFA concentration (mEq/L) was approximately 1.5-fold higher in CE stroke patients (1.01 ± 0.63) than in non-CE stroke patients (0.72 ± 0.51). Multivariate logistic analysis showed that an increased level of FFA was significantly associated with CE stroke (hazard ratio [HR] 2.124, confidence interval [CI] 1.492–3.024). During the mean follow-up period of 25.4 months, a total of 56 (8.4%) patients experienced a stroke recurrence. The recurrence rate did not differ between patients with CE (10.5%) and non-CE (8.0%) stroke (p = 0.396). In CE stroke patients, an elevated baseline FFA concentration was independently associated with stroke recurrence (HR 2.711, CI 1.056–6.959). However, there was no association between FFA and stroke recurrence in non-CE stroke patients.

Conclusion: In this retrospective registry-based observational study, CE stroke seemed to be associated with elevated plasma level of FFA. In addition, the present study suggested that an elevated FFA concentration could be a useful indicator for predicting recurrent stroke in CE stroke patients.

GLOSSARY

AF=
atrial fibrillation;
CAD=
coronary artery disease;
CE=
cardioembolic;
CRP=
C-reactive protein;
FFA=
free fatty acid;
HR=
hazard ratio;
NIHSS=
NIH Stroke Scale

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Editorial, page 1110

  • Received July 13, 2013.
  • Accepted in final form November 18, 2013.
  • © 2014 American Academy of Neurology
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