Lipid profiles and outcome in patients treated by intravenous thrombolysis for cerebral ischemia

Nardi, Katiuscia; Engelter, Stefan; Strbian, Daniel; Sarikaya, Hakan; Arnold, Marcel; Casoni, Federica; Ford, Gary A; Cordonnier, Charlotte; Lyrer, Philippe; Bordet, Régis; Soinne, Lauri; Gensicke, Henrik; Duriez, Patrick; Baumgartner, Ralf W; Tatlisumak, Turgut; Leys, Didier; On behalf of the Lipid Profile in Thrombolysis Study Group, (2012). Lipid profiles and outcome in patients treated by intravenous thrombolysis for cerebral ischemia. Neurology, 79(11), pp. 1101-1108. Hagerstown, Md.: Lippincott Williams & Wilkins 10.1212/WNL.0b013e3182608c82

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OBJECTIVE:To determine whether low low-density lipoprotein cholesterol (LDL-C) but not high-density lipoprotein cholesterol (HDL-C) and triglyceride concentrations are associated with worse outcome in a large cohort of ischemic stroke patients treated with IV thrombolysis. METHODS:Observational multicenter post hoc analysis of prospectively collected data in stroke thrombolysis registries. Because of collinearity between total cholesterol (TC) and LDL-C, we used 2 different models with TC (model 1) and with LDL-C (model 2). RESULTS:Of the 2,485 consecutive patients, 1,847 (74%) had detailed lipid profiles available. Independent predictors of 3-month mortality were lower serum HDL-C (adjusted odds ratio [(adj)OR] 0.531, 95% confidence interval [CI] 0.321-0.877 in model 1; (adj)OR 0.570, 95% CI 0.348-0.933 in model 2), lower serum triglyceride levels ((adj)OR 0.549, 95% CI 0.341-0.883 in model 1; (adj)OR 0.560, 95% CI 0.353-0.888 in model 2), symptomatic ICH, and increasing NIH Stroke Scale score, age, C-reactive protein, and serum creatinine. TC, LDL-C, HDL-C, and triglycerides were not independently associated with symptomatic ICH. Increased HDL-C was associated with an excellent outcome (modified Rankin Scale score 0-1) in model 1 ((adj)OR 1.390, 95% CI 1.040-1.860). CONCLUSION:Lower HDL-C and triglycerides were independently associated with mortality. These findings were not due to an association of lipid concentrations with symptomatic ICH and may reflect differences in baseline comorbidities, nutritional state, or a protective effect of triglycerides and HDL-C on mortality following acute ischemic stroke.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Sarikaya, Hakan and Arnold, Marcel

ISSN:

0028-3878

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:26

Last Modified:

08 Jun 2016 10:27

Publisher DOI:

10.1212/WNL.0b013e3182608c82

PubMed ID:

22843281

Web of Science ID:

000308745900027

URI:

https://boris.unibe.ch/id/eprint/9433 (FactScience: 215170)

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