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Contribution of Serum Lipid Profiles to Outcome After Endovascular Thrombectomy for Anterior Circulation Ischemic Stroke
The contribution of lipids, including low- and high-density lipoprotein cholesterol (LDL-C and HDL-C, respectively) and triglycerides (TG), to stroke outcomes is still debated. We sought to determine the impact of LDL-C concentrations on the outcome of patients with ischemic stroke in the anterior c...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer US
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6505499/ https://www.ncbi.nlm.nih.gov/pubmed/30353493 http://dx.doi.org/10.1007/s12035-018-1391-3 |
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author | Pikija, Slaven Sztriha, Laszlo K. Killer-Oberpfalzer, Monika Weymayr, Friedrich Hecker, Constantin Ramesmayer, Christian Hauer, Larissa Sellner, Johann |
author_facet | Pikija, Slaven Sztriha, Laszlo K. Killer-Oberpfalzer, Monika Weymayr, Friedrich Hecker, Constantin Ramesmayer, Christian Hauer, Larissa Sellner, Johann |
author_sort | Pikija, Slaven |
collection | PubMed |
description | The contribution of lipids, including low- and high-density lipoprotein cholesterol (LDL-C and HDL-C, respectively) and triglycerides (TG), to stroke outcomes is still debated. We sought to determine the impact of LDL-C concentrations on the outcome of patients with ischemic stroke in the anterior circulation who received treatment with endovascular thrombectomy (EVT). We performed a retrospective analysis of consecutive patients with acute ischemic stroke treated at a tertiary center between 2012 and 2016. Patients treated with EVT for large artery occlusion in the anterior circulation were selected. The primary endpoint was functional outcome at 3 months as measured with the modified Rankin Scale (mRS). Secondary outcome measures included hospital death and final infarct volume (FIV). Blood lipid levels were determined in a fasting state, 1 day after admission. We studied a total of 174 patients (44.8% men) with a median age of 74 years (interquartile range [IQR] 61–82) and median National Institutes of Health Stroke Scale at admission of 18 (14–22). Bridging therapy with intravenous tissue-plasminogen activator (t-PA) was administered in 122 (70.5%). The median LDL-C was 90 mg/dl (72–115). LDL-C demonstrated a U-type relationship with FIV (p = 0.036). Eighty-three (50.0%) patients had an mRS of 0–2 at 3 months. This favorable outcome was independently associated with younger age (OR 0.944, 95% CI 0.90–0.99, p = 0.012), thrombolysis in cerebral infarction 2b-3 reperfusion (OR 5.12, 95% CI 1.01–25.80, p = 0.015), smaller FIV (0.97 per cm(3), 95% CI 0.97–0.99, p < 0.001), good leptomeningeal collaterals (OR 5.29, 95% CI 1.48–18.9, p = 0.011), and LDL-C more than 77 mg/dl (OR 0.179, 95% CI 0.04–0.74, p = 0.018). A higher LDL-C concentration early in the course of a stroke caused by large artery occlusion in the anterior circulation is independently associated with a favorable clinical outcome at 3 months. Further studies into the pathophysiological mechanisms underlying this observation are warranted. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s12035-018-1391-3) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6505499 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-65054992019-05-28 Contribution of Serum Lipid Profiles to Outcome After Endovascular Thrombectomy for Anterior Circulation Ischemic Stroke Pikija, Slaven Sztriha, Laszlo K. Killer-Oberpfalzer, Monika Weymayr, Friedrich Hecker, Constantin Ramesmayer, Christian Hauer, Larissa Sellner, Johann Mol Neurobiol Article The contribution of lipids, including low- and high-density lipoprotein cholesterol (LDL-C and HDL-C, respectively) and triglycerides (TG), to stroke outcomes is still debated. We sought to determine the impact of LDL-C concentrations on the outcome of patients with ischemic stroke in the anterior circulation who received treatment with endovascular thrombectomy (EVT). We performed a retrospective analysis of consecutive patients with acute ischemic stroke treated at a tertiary center between 2012 and 2016. Patients treated with EVT for large artery occlusion in the anterior circulation were selected. The primary endpoint was functional outcome at 3 months as measured with the modified Rankin Scale (mRS). Secondary outcome measures included hospital death and final infarct volume (FIV). Blood lipid levels were determined in a fasting state, 1 day after admission. We studied a total of 174 patients (44.8% men) with a median age of 74 years (interquartile range [IQR] 61–82) and median National Institutes of Health Stroke Scale at admission of 18 (14–22). Bridging therapy with intravenous tissue-plasminogen activator (t-PA) was administered in 122 (70.5%). The median LDL-C was 90 mg/dl (72–115). LDL-C demonstrated a U-type relationship with FIV (p = 0.036). Eighty-three (50.0%) patients had an mRS of 0–2 at 3 months. This favorable outcome was independently associated with younger age (OR 0.944, 95% CI 0.90–0.99, p = 0.012), thrombolysis in cerebral infarction 2b-3 reperfusion (OR 5.12, 95% CI 1.01–25.80, p = 0.015), smaller FIV (0.97 per cm(3), 95% CI 0.97–0.99, p < 0.001), good leptomeningeal collaterals (OR 5.29, 95% CI 1.48–18.9, p = 0.011), and LDL-C more than 77 mg/dl (OR 0.179, 95% CI 0.04–0.74, p = 0.018). A higher LDL-C concentration early in the course of a stroke caused by large artery occlusion in the anterior circulation is independently associated with a favorable clinical outcome at 3 months. Further studies into the pathophysiological mechanisms underlying this observation are warranted. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s12035-018-1391-3) contains supplementary material, which is available to authorized users. Springer US 2018-10-23 2019 /pmc/articles/PMC6505499/ /pubmed/30353493 http://dx.doi.org/10.1007/s12035-018-1391-3 Text en © The Author(s) 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Article Pikija, Slaven Sztriha, Laszlo K. Killer-Oberpfalzer, Monika Weymayr, Friedrich Hecker, Constantin Ramesmayer, Christian Hauer, Larissa Sellner, Johann Contribution of Serum Lipid Profiles to Outcome After Endovascular Thrombectomy for Anterior Circulation Ischemic Stroke |
title | Contribution of Serum Lipid Profiles to Outcome After Endovascular Thrombectomy for Anterior Circulation Ischemic Stroke |
title_full | Contribution of Serum Lipid Profiles to Outcome After Endovascular Thrombectomy for Anterior Circulation Ischemic Stroke |
title_fullStr | Contribution of Serum Lipid Profiles to Outcome After Endovascular Thrombectomy for Anterior Circulation Ischemic Stroke |
title_full_unstemmed | Contribution of Serum Lipid Profiles to Outcome After Endovascular Thrombectomy for Anterior Circulation Ischemic Stroke |
title_short | Contribution of Serum Lipid Profiles to Outcome After Endovascular Thrombectomy for Anterior Circulation Ischemic Stroke |
title_sort | contribution of serum lipid profiles to outcome after endovascular thrombectomy for anterior circulation ischemic stroke |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6505499/ https://www.ncbi.nlm.nih.gov/pubmed/30353493 http://dx.doi.org/10.1007/s12035-018-1391-3 |
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