Annahita Sedghi, Sonja Schreckenbauer, Daniel P O Kaiser, Ani Cuberi, Witold H Polanski, Martin Arndt, Kristian Barlinn, Volker Puetz, Timo Siepmann
{"title":"高密度脂蛋白胆固醇与缺血性脑卒中取栓后颅内出血减少和良好功能结局的关联：倾向匹配分析","authors":"Annahita Sedghi, Sonja Schreckenbauer, Daniel P O Kaiser, Ani Cuberi, Witold H Polanski, Martin Arndt, Kristian Barlinn, Volker Puetz, Timo Siepmann","doi":"10.1186/s42466-025-00373-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Animal studies suggest that high-density lipoprotein cholesterol (HDL-C) attenuates reperfusion injury. We aimed to assess whether higher serum HDL-C levels modulate the risk of intracranial haemorrhage (ICH) after thrombectomy in human stroke survivors.</p><p><strong>Methods: </strong>We included consecutive patients from our prospective anterior circulation large vessel occlusion (acLVO) registry who underwent thrombectomy between 01/2017 and 01/2023 at the tertiary stroke centre of the University Hospital Carl Gustav Carus in Dresden, Germany in a propensity score-matched analysis. We assessed the association between serum HDL-C levels and post-interventional ICH as well as 90-day functional outcome quantified by the modified Rankin Scale (mRS). For sensitivity analysis, we used multivariable lasso logistic regression. Analyses were adjusted for demographics, cardiovascular risk profiles, stroke characteristics, and procedural times.</p><p><strong>Results: </strong>Of 1702 patients screened, 807 (420 women, median age 77 years [66-84, IQR]) were included. Post-interventional ICH reduced the probability of a favourable functional outcome (90-day mRS 0-2) by 14.8% (ß = 0.15; 95% CI [0.06;0.24]; p = 0.001. An HDL-C level above the median (1.15 mmol/L) decreased the probability of ICH by 13.6% (ß = - 0.14; 95CI% [- 0.22; - 0.05]; p = 0.002) and increased the probability of favourable functional outcome by 13.2% (ß = - 0.13; 95CI% [- 0.22; - 0.05]; p = 0.003). In sensitivity analyses, higher HDL-C levels were independently associated with lower odds of ICH (adjusted OR 0.62; 95% CI [0.43;0.88]; p = 0.008) and higher odds of favourable functional outcome (adjusted OR 0.60; 95% CI [0.40; 0.90]; p = 0.015).</p><p><strong>Conclusions: </strong>In patients undergoing thrombectomy for acLVO, higher HDL-C levels were associated with a reduced probability of post-interventional ICH and a favourable functional outcome. These observations could not be explained by conventional vascular risk profiles.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"7 1","pages":"16"},"PeriodicalIF":0.0000,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921977/pdf/","citationCount":"0","resultStr":"{\"title\":\"Association of high-density lipoprotein cholesterol with reduced intracranial haemorrhage and favourable functional outcome after thrombectomy for ischaemic stroke: a propensity-matched analysis.\",\"authors\":\"Annahita Sedghi, Sonja Schreckenbauer, Daniel P O Kaiser, Ani Cuberi, Witold H Polanski, Martin Arndt, Kristian Barlinn, Volker Puetz, Timo Siepmann\",\"doi\":\"10.1186/s42466-025-00373-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Animal studies suggest that high-density lipoprotein cholesterol (HDL-C) attenuates reperfusion injury. We aimed to assess whether higher serum HDL-C levels modulate the risk of intracranial haemorrhage (ICH) after thrombectomy in human stroke survivors.</p><p><strong>Methods: </strong>We included consecutive patients from our prospective anterior circulation large vessel occlusion (acLVO) registry who underwent thrombectomy between 01/2017 and 01/2023 at the tertiary stroke centre of the University Hospital Carl Gustav Carus in Dresden, Germany in a propensity score-matched analysis. We assessed the association between serum HDL-C levels and post-interventional ICH as well as 90-day functional outcome quantified by the modified Rankin Scale (mRS). For sensitivity analysis, we used multivariable lasso logistic regression. Analyses were adjusted for demographics, cardiovascular risk profiles, stroke characteristics, and procedural times.</p><p><strong>Results: </strong>Of 1702 patients screened, 807 (420 women, median age 77 years [66-84, IQR]) were included. Post-interventional ICH reduced the probability of a favourable functional outcome (90-day mRS 0-2) by 14.8% (ß = 0.15; 95% CI [0.06;0.24]; p = 0.001. An HDL-C level above the median (1.15 mmol/L) decreased the probability of ICH by 13.6% (ß = - 0.14; 95CI% [- 0.22; - 0.05]; p = 0.002) and increased the probability of favourable functional outcome by 13.2% (ß = - 0.13; 95CI% [- 0.22; - 0.05]; p = 0.003). In sensitivity analyses, higher HDL-C levels were independently associated with lower odds of ICH (adjusted OR 0.62; 95% CI [0.43;0.88]; p = 0.008) and higher odds of favourable functional outcome (adjusted OR 0.60; 95% CI [0.40; 0.90]; p = 0.015).</p><p><strong>Conclusions: </strong>In patients undergoing thrombectomy for acLVO, higher HDL-C levels were associated with a reduced probability of post-interventional ICH and a favourable functional outcome. These observations could not be explained by conventional vascular risk profiles.</p>\",\"PeriodicalId\":94156,\"journal\":{\"name\":\"Neurological research and practice\",\"volume\":\"7 1\",\"pages\":\"16\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-03-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921977/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neurological research and practice\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1186/s42466-025-00373-4\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurological research and practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s42466-025-00373-4","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
背景：动物研究表明高密度脂蛋白胆固醇（HDL-C）可减轻再灌注损伤。我们的目的是评估较高的血清HDL-C水平是否调节人类中风幸存者取栓后颅内出血（ICH）的风险。方法：我们纳入了前瞻性前循环大血管闭塞（acLVO）登记的连续患者，这些患者于2017年1月1日至2023年1月在德国德累斯顿卡尔古斯塔夫Carus大学医院三级卒中中心接受了血栓切除术，并进行了倾向评分匹配分析。我们评估了血清HDL-C水平与介入后脑出血以及用改良Rankin量表（mRS）量化的90天功能结局之间的关系。对于敏感性分析，我们使用多变量套索逻辑回归。根据人口统计学、心血管风险概况、卒中特征和手术时间对分析进行了调整。结果：在筛查的1702例患者中，纳入807例（420例女性，中位年龄77岁[66-84，IQR]）。介入后脑出血使功能预后良好的概率（90天mRS 0-2）降低了14.8% (ß = 0.15；95% ci [0.06;0.24]；p = 0.001。高于中位数（1.15 mmol/L）的HDL-C水平使脑出血的概率降低13.6% (ß = - 0.14；95% ci % [- 0.22；- 0.05);P = 0.002)，并使功能预后良好的概率增加13.2% (ß = - 0.13；95% ci % [- 0.22；- 0.05);p = 0.003)。在敏感性分析中，较高的HDL-C水平与较低的脑出血几率独立相关(调整OR 0.62；95% ci [0.43;0.88]；p = 0.008)和较高的功能预后良好的几率(调整OR 0.60；95% ci [0.40；0.90);p = 0.015)。结论：在因acLVO而接受血栓切除术的患者中，较高的HDL-C水平与介入后脑出血的可能性降低和良好的功能预后相关。这些观察结果不能用传统的血管风险概况来解释。
Association of high-density lipoprotein cholesterol with reduced intracranial haemorrhage and favourable functional outcome after thrombectomy for ischaemic stroke: a propensity-matched analysis.
Background: Animal studies suggest that high-density lipoprotein cholesterol (HDL-C) attenuates reperfusion injury. We aimed to assess whether higher serum HDL-C levels modulate the risk of intracranial haemorrhage (ICH) after thrombectomy in human stroke survivors.
Methods: We included consecutive patients from our prospective anterior circulation large vessel occlusion (acLVO) registry who underwent thrombectomy between 01/2017 and 01/2023 at the tertiary stroke centre of the University Hospital Carl Gustav Carus in Dresden, Germany in a propensity score-matched analysis. We assessed the association between serum HDL-C levels and post-interventional ICH as well as 90-day functional outcome quantified by the modified Rankin Scale (mRS). For sensitivity analysis, we used multivariable lasso logistic regression. Analyses were adjusted for demographics, cardiovascular risk profiles, stroke characteristics, and procedural times.
Results: Of 1702 patients screened, 807 (420 women, median age 77 years [66-84, IQR]) were included. Post-interventional ICH reduced the probability of a favourable functional outcome (90-day mRS 0-2) by 14.8% (ß = 0.15; 95% CI [0.06;0.24]; p = 0.001. An HDL-C level above the median (1.15 mmol/L) decreased the probability of ICH by 13.6% (ß = - 0.14; 95CI% [- 0.22; - 0.05]; p = 0.002) and increased the probability of favourable functional outcome by 13.2% (ß = - 0.13; 95CI% [- 0.22; - 0.05]; p = 0.003). In sensitivity analyses, higher HDL-C levels were independently associated with lower odds of ICH (adjusted OR 0.62; 95% CI [0.43;0.88]; p = 0.008) and higher odds of favourable functional outcome (adjusted OR 0.60; 95% CI [0.40; 0.90]; p = 0.015).
Conclusions: In patients undergoing thrombectomy for acLVO, higher HDL-C levels were associated with a reduced probability of post-interventional ICH and a favourable functional outcome. These observations could not be explained by conventional vascular risk profiles.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
