Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jun;56(6):4582-4588.
doi: 10.1007/s12035-018-1391-3. Epub 2018 Oct 23.

Contribution of Serum Lipid Profiles to Outcome After Endovascular Thrombectomy for Anterior Circulation Ischemic Stroke

Slaven Pikija  1 , Laszlo K Sztriha  2 , Monika Killer-Oberpfalzer  3 , Friedrich Weymayr  4 , Constantin Hecker  1 , Christian Ramesmayer  1 , Larissa Hauer  5 , Johann Sellner  6   7
Affiliations

Contribution of Serum Lipid Profiles to Outcome After Endovascular Thrombectomy for Anterior Circulation Ischemic Stroke

Slaven Pikija et al. Mol Neurobiol. 2019 Jun.

Abstract

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 cm3, 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.

Keywords: Cholesterol; Ischemic stroke; Low-density lipoprotein; Outcome; Thrombectomy.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
U-shape relationship of low-density lipoprotein with infarct volume in patients treated for large artery anterior stroke with endovascular thrombectomy
Fig. 2
Fig. 2
mRS outcomes at 3 months according to low or high LDL-C levels in 174 patients treated with endovascular thrombectomy for large artery anterior circulation stroke
See this image and copyright information in PMC

References

    1. Feigin VL, Norrving B, Mensah GA. Global burden of stroke. Circ Res. 2017;120(3):439–448. doi: 10.1161/CIRCRESAHA.116.308413. - DOI - PubMed
    1. O'Donnell MJ, Chin SL, Rangarajan S, Xavier D, Liu L, Zhang H, Rao-Melacini P, Zhang X, Pais P, Agapay S, Lopez-Jaramillo P, Damasceno A, Langhorne P, McQueen MJ, Rosengren A, Dehghan M, Hankey GJ, Dans AL, Elsayed A, Avezum A, Mondo C, Diener HC, Ryglewicz D, Czlonkowska A, Pogosova N, Weimar C, Iqbal R, Diaz R, Yusoff K, Yusufali A, Oguz A, Wang X, Penaherrera E, Lanas F, Ogah OS, Ogunniyi A, Iversen HK, Malaga G, Rumboldt Z, Oveisgharan S, Al Hussain F, Magazi D, Nilanont Y, Ferguson J, Pare G, Yusuf S, investigators I. Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study. Lancet. 2016;388(10046):761–775. doi: 10.1016/S0140-6736(16)30506-2. - DOI - PubMed
    1. Nayor M, Vasan RS. Recent update to the US cholesterol treatment guidelines: a comparison with international guidelines. Circulation. 2016;133(18):1795–1806. doi: 10.1161/CIRCULATIONAHA.116.021407. - DOI - PMC - PubMed
    1. Koton S, Molshatzki N, Bornstein NM, Tanne D. Low cholesterol, statins and outcomes in patients with first-ever acute ischemic stroke. Cerebrovasc Dis. 2012;34(3):213–220. doi: 10.1159/000342302. - DOI - PubMed
    1. Markaki I, Nilsson U, Kostulas K, Sjostrand C. High cholesterol levels are associated with improved long-term survival after acute ischemic stroke. J Stroke Cerebrovasc Dis. 2014;23(1):e47–e53. doi: 10.1016/j.jstrokecerebrovasdis.2013.08.009. - DOI - PubMed