较高的高密度脂蛋白胆固醇水平与卒中溶栓后的不利结果相关:脂质悖论

IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY
Ming-Ya Luo, Fu-Liang Zhang, Shan Lv, Yu Song, Yao Yu, Zhen-Ni Guo, Yi Yang
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引用次数: 0

摘要

背景血清胆固醇水平对脑卒中预后的影响仍然存在争议,特别是在静脉溶栓治疗的患者中。本研究探讨了接受重组组织型纤溶酶原激活剂(rt-PA) IVT的急性缺血性卒中(AIS)患者的脂质水平与预后之间的关系。方法回顾性分析2015年4月至2018年12月接受rt-PA溶栓治疗的AIS患者。收集空腹脂质谱,包括总胆固醇、甘油三酯、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇(HDL-C)。卒中结局包括出血性转化、3个月不良预后(修正Rankin量表)和3个月死亡率。结果纳入698例接受ivt治疗的AIS患者。二元logistic回归分析显示,较高的HDL-C水平与较高的3个月不良结局风险独立相关(优势比1.999,95%置信区间1.204 ~ 3.320,p = 0.007)。然后根据HDL-C的临界值1.415 mmol/L将患者分为高、低HDL-C组。在倾向评分匹配调整基线因素后,高HDL-C组患者比低HDL-C组患者更有可能经历3个月的不良结果(p = 0.041)。结论:在接受ivt治疗的AIS患者中,较高的HDL-C水平与3个月的不良预后独立相关。本研究已获得吉林大学第一医院伦理委员会批准(No. 5);NCT05028868)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Higher High-Density Lipoprotein Cholesterol Levels Are Associated With an Unfavorable Outcome After Thrombolysis for Stroke: The Lipid Paradox

Higher High-Density Lipoprotein Cholesterol Levels Are Associated With an Unfavorable Outcome After Thrombolysis for Stroke: The Lipid Paradox

Background

Effects of serum cholesterol levels on stroke outcomes remain controversial, especially in intravenous thrombolysis (IVT)–treated patients. This study explored the association between lipid levels and outcomes in patients with acute ischemic stroke (AIS) who received IVT with recombinant tissue plasminogen activator (rt-PA).

Methods

AIS patients who received rt-PA thrombolysis from April 2015 to December 2018 were retrospectively enrolled. Fasting lipid profiles, including total cholesterol, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol (HDL-C), were collected. Stroke outcomes included hemorrhagic transformation, 3-month unfavorable outcome (modified Rankin scale > 2), and 3-month mortality.

Results

We enrolled 698 IVT-treated patients with AIS. Binary logistic regression analysis showed that a higher HDL-C level was independently associated with a higher risk of a 3-month unfavorable outcome (odds ratio 1.999, 95% confidence interval 1.204–3.320, p = 0.007). Patients were then divided into high and low HDL-C groups according to a cutoff HDL-C of 1.415 mmol/L. After propensity score matching to adjust for baseline factors, patients in the high HDL-C group were more likely to experience a 3-month unfavorable outcome than those in the low HDL-C group (p = 0.041).

Conclusions

A higher HDL-C level was independently associated with a 3-month unfavorable outcome in IVT-treated patients with AIS. The current study received approval from the Ethics Committee of the First Hospital of Jilin University (No. NCT05028868).

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来源期刊
Acta Neurologica Scandinavica
Acta Neurologica Scandinavica 医学-临床神经学
CiteScore
6.70
自引率
2.90%
发文量
161
审稿时长
4-8 weeks
期刊介绍: Acta Neurologica Scandinavica aims to publish manuscripts of a high scientific quality representing original clinical, diagnostic or experimental work in neuroscience. The journal''s scope is to act as an international forum for the dissemination of information advancing the science or practice of this subject area. Papers in English will be welcomed, especially those which bring new knowledge and observations from the application of therapies or techniques in the combating of a broad spectrum of neurological disease and neurodegenerative disorders. Relevant articles on the basic neurosciences will be published where they extend present understanding of such disorders. Priority will be given to review of topical subjects. Papers requiring rapid publication because of their significance and timeliness will be included as ''Clinical commentaries'' not exceeding two printed pages, as will ''Clinical commentaries'' of sufficient general interest. Debate within the speciality is encouraged in the form of ''Letters to the editor''. All submitted manuscripts falling within the overall scope of the journal will be assessed by suitably qualified referees.
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