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

Lookup NU author(s): Professor Gary Ford


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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 [adjOR] 0.531, 95% confidence interval [CI] 0.321-0.877 in model 1; adjOR 0.570, 95% CI 0.348-0.933 in model 2), lower serum triglyceride levels (adjOR 0.549, 95% CI 0.341-0.883 in model 1; adjOR 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 (adjOR 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. Neurology (R) 2012;79:1101-1108

Publication metadata

Author(s): Nardi K, Engelter S, Strbian D, Sarikaya H, Arnold M, Casoni F, Ford GA, Cordonnier C, Lyrer P, Bordet R, Soinne L, Gensicke H, Duriez P, Baumgartner RW, Tatlisumak T, Leys D, Lipid Profile Thrombolysis Study G

Publication type: Article

Publication status: Published

Journal: Neurology

Year: 2012

Volume: 79

Issue: 11

Pages: 1101-1108

Print publication date: 25/07/2012

ISSN (print): 0028-3878

ISSN (electronic): 1526-632X

Publisher: Lippincott Williams & Wilkins


DOI: 10.1212/WNL.0b013e3182608c82


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