Effect of Serum Lipid Levels on Stroke Outcome after rt-PA Therapy: SAMURAI rt-PA Registry
- 19 January 2012
- journal article
- research article
- Published by S. Karger AG in Cerebrovascular Diseases
- Vol. 33 (3), 240-247
- https://doi.org/10.1159/000334664
Abstract
Background: The effects of lipid levels on clinical outcomes after ischemic stroke are controversial. Whether admission lipid levels and prior statin use are associated with early intracerebral hemorrhage (ICH) and long-term functional outcome after recombinant tissue plasminogen activator (rt-PA) therapy for stroke patients was investigated. Methods: Ischemic stroke patients who received intravenous rt-PA from a multicenter registry were studied. Lipid levels on admission, including total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, and triglyceride levels, as well as prior statin use, were assessed. The primary outcome was favorable outcome at 3 months corresponding to a modified Rankin Scale score ≤1. The secondary outcome was any or symptomatic ICH within the initial 36 h. Results: Of 489 enrolled patients (171 women, 70.8 ± 11.6 years old), 60 used statins prior to stroke, 93 developed ICH (19.0%), and 188 (38.4%) had a favorable 3-month outcome. Of the lipid levels, only the HDL-C level was an independent predictor of favorable outcome after multivariate adjustment for baseline characteristics (OR 1.95, 95% CI 1.10–3.47 per 1 mmol/l; p = 0.023) and after further adjustment for pretreatment radiological findings (OR 2.03, 95% CI 1.07–3.84; p = 0.029). For the 187 stroke patients without cardioembolism, the HDL-C level was more strongly associated with favorable outcome (OR 4.94, 95% CI 1.91–12.76 per 1 mmol/l; p = 0.001). There were no significant associations between ICH and any lipid levels. Prior statin use was not associated with outcomes. Conclusions: The admission HDL-C level was associated with favorable outcome 3 months after intravenous rt-PA therapy in stroke patients without cardioembolism.Keywords
This publication has 43 references indexed in Scilit:
- Pretreatment with statins improves early outcome in patients with first-ever ischaemic stroke: a pleiotropic effect of statins or a beneficial effect of hypercholesterolemia?BMC Neurology, 2010
- Impact of Hyperlipidemia and Statins on Ischemic Stroke Outcomes after Intra-Arterial Fibrinolysis and Percutaneous Mechanical EmbolectomyCerebrovascular Diseases, 2009
- Effect of Pretreatment With Statins on Ischemic Stroke OutcomesStroke, 2008
- Outline of the Japanese Guidelines for the Management of Stroke 2004 and Subsequent RevisionInternational Journal of Stroke, 2008
- High-Density Lipoprotein CholesterolStroke, 2007
- Prior Statin Use May Be Associated With Improved Stroke Outcome After Tissue Plasminogen ActivatorStroke, 2007
- Lipid levels and the risk of ischemic stroke in womenNeurology, 2007
- Reconstituted High-Density Lipoprotein Exhibits Neuroprotection in Two Rat Models of StrokeCerebrovascular Diseases, 2003
- Different Risk Factors for Different Stroke SubtypesStroke, 1999
- Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment.Stroke, 1993