title: Influence of lipid profiles on the risk of hemorrhagic transformation after ischemic stroke: systematic review.
abstract: BACKGROUND
  It has been suggested that low cholesterol levels might be associated with an increased risk of hemorrhagic transformation (HT) in patients with acute cerebral ischemia. We systematically reviewed the literature to determine the influence of lipid profiles on the HT risk.
  
  
  METHODS
  We searched PubMed from 1966 and EMBASE from 1980 for studies that investigated the association between lipid profiles and HT. We performed a meta-analysis (weighted mean difference method) for the comparison between presence and absence of HT (all or symptomatic) for total, low-density-lipoprotein (LDL) and high-density-lipoprotein (HDL) cholesterol, and triglycerides.
  
  
  RESULTS
  Eight studies investigating 1,763 patients were eligible, but none was designed specifically to address this question. All studies recruited acute stroke patients selected on the presumed cause of cerebral ischemia or treatment received. The meta-analysis showed that: (i) patients with all HT had lower LDL cholesterol levels (p = 0.008) but no difference in HDL cholesterol levels (p = 0.066), total cholesterol (p = 0.129) and triglycerides (p = 0.900); (ii) patients with symptomatic HT had lower total cholesterol levels (p = 0.035) but did not differ in LDL (p = 0.056) and HDL cholesterol (p = 0.138) and triglyceride (p = 0.851) levels.
  
  
  CONCLUSIONS
  HT is associated with baseline total and LDL cholesterol levels, but the mechanism of this association needs to be explored to identify preventive strategies.
authors.affiliation: Department of Neurology, Université Lille Nord de France, Lille, France.
authors.forename: Katiuscia
authors.initials: K
authors.lastname: Nardi
authors.forename: Didier
authors.initials: D
authors.lastname: Leys
authors.forename: Paolo
authors.initials: P
authors.lastname: Eusebi
authors.forename: Charlotte
authors.initials: C
authors.lastname: Cordonnier
authors.forename: Sophie
authors.initials: S
authors.lastname: Gautier
authors.forename: Hilde
authors.initials: H
authors.lastname: Hénon
authors.forename: Régis
authors.initials: R
authors.lastname: Bordet