title: Lipid profiles and outcome in patients treated by intravenous thrombolysis for cerebral ischemia.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors: Stroke Unit and Department of Neurology, University Hospital of Lille, Lille, France.
authors: Katiuscia
authors: K
authors: Nardi
authors: Stefan
authors: S
authors: Engelter
authors: Daniel
authors: D
authors: Strbian
authors: Hakan
authors: H
authors: Sarikaya
authors: Marcel
authors: M
authors: Arnold
authors: Federica
authors: F
authors: Casoni
authors: Gary A
authors: GA
authors: Ford
authors: Charlotte
authors: C
authors: Cordonnier
authors: Philippe
authors: P
authors: Lyrer
authors: Régis
authors: R
authors: Bordet
authors: Lauri
authors: L
authors: Soinne
authors: Henrik
authors: H
authors: Gensicke
authors: Patrick
authors: P
authors: Duriez
authors: Ralf W
authors: RW
authors: Baumgartner
authors: Turgut
authors: T
authors: Tatlisumak
authors: Didier
authors: D
authors: Leys
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000097:blood* / Q000188:drug therapy / Q000401:mortality; D002784:Cholesterol / Q000097:blood*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D020521:Stroke / Q000097:blood* / Q000188:drug therapy / Q000401:mortality; D015912:Thrombolytic Therapy / Q000401:mortality; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood*
chemical_list: D005343:Fibrinolytic Agents; D014280:Triglycerides; D002784:Cholesterol; D010959:Tissue Plasminogen Activator