Association between non-high-density lipoprotein cholesterol and haemorrhagic transformation in patients with acute ischaemic stroke

Wang, Yanan; Song, Quhong; Cheng, Yajun; Wei, Chuanliang; Ye, Chen; Liu, Junfeng; Wu, Bo; Liu, Ming

doi:10.1186/s12883-020-1615-9

Cited by 16 publications

(14 citation statements)

References 50 publications

(44 reference statements)

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“….83], respectively, P for trend = 0.024). [21] With the current studies, the associations between LDL and the incidence of ICH was warrant to be tested. There were many limitations within the current study.…”

Section: Discussionmentioning

confidence: 96%

Associations between Intensive Lipid-lowering Therapy and Outcomes of Intracerebral Hemorrhage

Tang¹

2021

JNNS

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Background: The intensive lipid-lowering therapy (ILLT), targeting an low-density lipoprotein cholesterol (LDL-C) < 1.80 mmol/L, was a crucial strategy for the secondary prevention of cerebrovascular diseases. But the associations between ILLT and the outcomes after intracerebral hemorrhage (ICH) were unclear. Materials and Methods: Data of the consecutive patients with acute ICH and past medical histories of ischemic stroke from 2017 to 2019 at an academic stroke center in China were analyzed. The study patients were classified according to their baseline LDL-C levels: < 1.80 mmol/Lvs. ≥ 1.80 mmol/L. The outcomes of ICH were compared between the two groups. Multivariate linear mixed effect model with repeated measures adjusting for ICH scores were used to determine the associations between LDL-C levels and the change in NIHSS scores; baseline ICH scores were adjusted in the multi-variable models Results: A total of 197 patients were included in the study, 31 of them had LDL-C < 1.80 mmol/L and 166 had LDL-C ≥ 1.80 mmol/L. We did not test any significant differences regarding the demographic characteristics or vascular risk factors. Medians of the baseline National Institutes of Health Stroke Scale (NIHSS) scores (8 vs. 9, P = 0.79) and ICH scores (1 vs.1, P = 0.26) were similar. But the patients with LDL-C < 1.80 mmol/L had higher risks of secondary intraventricular hemorrhage (13% vs. 4%, P = 0.03). Outcomes of the hemorrhagic stroke at discharge were similar, except the patients with LDL-C ≥ 1.80 mmol/L had significant improvements in their NIHSS scores at discharge (estimated change in means: -2.4, 95% CI: [-4.3, -0.5]), while patients with LDL-C < 1.80 mmol/L did not (estimated change in means: -1.4, 95% CI: [-5.9, 3.0]). Conclusion: ILLT achieved LDL-C < 1.80 mmol/L was associated with limited improvements in the neurological deficits in the patients with ICH.

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Section: Discussionmentioning

confidence: 96%

Associations between Intensive Lipid-lowering Therapy and Outcomes of Intracerebral Hemorrhage

Tang¹

2021

JNNS

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“…On the other hand, a lower LDL/HDL ratio was linked to worse outcomes at three months (including death, recurrence, and moderate disability) after stroke [ 29 ]. In another study, low levels of non-HDL cholesterol and LDL were associated with an increased risk of hemorrhagic transformation after ischemic stroke [ 30 ]. However, these studies, including our study, demonstrate associations, not causative relationships, and the mechanisms underlying these associations are still to be identified.…”

Section: Discussionmentioning

confidence: 99%

Association of Dilated Perivascular Spaces With Lipid Indices in Ischemic Stroke Patients

Diker¹,

Gelener²,

Erem³

et al. 2022

Cureus

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BackgroundDilated perivascular spaces (dPVS) in the basal ganglia are associated with aging, vascular risk factors, and other magnetic resonance imaging (MRI) markers of cerebral small vessel disease (cSVD). While high blood lipids are a well-demonstrated risk factor for large artery atherosclerosis, their role in cSVD remains largely elusive. MethodsWe evaluated lipid profiles, cardiovascular risk factors, and brain MRI findings in patients with ischemic stroke or transient ischemic attack. We analyzed the extent of dPVS, cerebral microbleed (CMB), and cerebral white matter hyperintensities (WMHs) as MRI indices of cSVD and investigated associations of dPVS with lipid parameters and other cSVD indices. ResultsOur study enrolled 173 patients with ischemic stroke or transient ischemic attack. The mean age was 68.38±14.31 (range 35-99) years, and 57.8% (n=100) of patients were male. dPVS were detected in 97% (n=168) of the patients. Among the whole population, half of the patients (n=87) had moderate to severe dPVS. According to the univariate analysis, age, hypertension, previous antiaggregant and/or anticoagulant use, and the high-density lipoprotein to low-density lipoprotein (HDL/LDL) ratio but not other lipid profiles, cerebral microbleed load, and cerebral white matter hyperintensities severity were found to be positively associated with dPVS number in the basal ganglia. After multivariate logistic regression analysis, only age and WMH severity remained statistically significant. ConclusionsdPVS are closely associated with other cSVD subtypes and aging. The studied lipid indices were not independently associated with moderate to severe dPVS in basal ganglia in ischemic stroke patients. The association of each lipid and HDL/LDL ratio needs to be further studied with a larger number of participants.

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“…Studies have shown that atherosclerosis (AS) is the most common cause of AIS, and dyslipidemia is the most important risk factor of AS (3,4). Many blood lipid parameters have been used to evaluate the risk of stroke outcomes, such as total cholesterol (TC), triglyceride (TG), lowdensity lipoprotein (LDL-C), high-density lipoprotein (HDL-C), non-HDL-C, and other parameters (5)(6)(7)(8), but the predictive values of these indicators are still limited.…”

Section: Introductionmentioning

confidence: 99%

Atherogenic Index of Plasma Predicts Outcomes in Acute Ischemic Stroke

Liu

Pei

et al. 2021

Front. Neurol.

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Aim: The atherogenic index of plasma (AIP) was significantly related to adverse outcomes in patients with cardiovascular disease. Our aim was to investigate the association between AIP and adverse outcomes in acute ischemic stroke.Methods: Patients with acute ischemic stroke (AIS) admitted between 2015 and 2018 were prospectively enrolled in this study. Functional outcomes were evaluated by the modified Rankin Scale (mRS). Poor outcomes were defined as mRS 3–6. The relationship of AIP with the risk of outcomes was analyzed by multivariate logistic regression models.Results: A total of 1,463 patients with AIS within 24 h of symptom onset were enrolled. The poor outcome group had a significantly higher level of AIP [0.09 (−0.10 to 0.27) vs. 0.04 (−0.09 to 0.18), p < 0.001] compared with the good outcome group. Multivariable logistic regression analysis showed that higher AIP was associated with poor outcomes in all the stroke patients (OR 1.84, 95% CI, 1.23–2.53, p = 0.007), which was more evident in patients with large-artery atherosclerosis subtype (OR 1.90, 95% CI, 1.53–2.62, p = 0.002), but not in the other subtypes. Receiver operating curve (ROC) analysis revealed that the best predictive cutoff value of AIP was 0.112, with a sensitivity of 70.8% and a specificity of 59.2%, and the area under the ROC curves for AIP was 0.685.Conclusion: AIP may be an important and independent predictor of the outcome of dysfunction in patients with AIS, especially the stroke subtype of large-artery atherosclerosis.

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Association between non-high-density lipoprotein cholesterol and haemorrhagic transformation in patients with acute ischaemic stroke

Cited by 16 publications

References 50 publications

Associations between Intensive Lipid-lowering Therapy and Outcomes of Intracerebral Hemorrhage

Associations between Intensive Lipid-lowering Therapy and Outcomes of Intracerebral Hemorrhage

Association of Dilated Perivascular Spaces With Lipid Indices in Ischemic Stroke Patients

Atherogenic Index of Plasma Predicts Outcomes in Acute Ischemic Stroke

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