Ming-Ya Luo, Fu-Liang Zhang, Shan Lv, Yu Song, Yao Yu, Zhen-Ni Guo, Yi Yang
{"title":"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","authors":"Ming-Ya Luo, Fu-Liang Zhang, Shan Lv, Yu Song, Yao Yu, Zhen-Ni Guo, Yi Yang","doi":"10.1155/ane/1668467","DOIUrl":null,"url":null,"abstract":"<div>\n \n <section>\n \n <h3> Background</h3>\n \n <p>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).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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, <i>p</i> = 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 (<i>p</i> = 0.041).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>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).</p>\n </section>\n </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2025 1","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/1668467","citationCount":"0","resultStr":"{\"title\":\"Higher High-Density Lipoprotein Cholesterol Levels Are Associated With an Unfavorable Outcome After Thrombolysis for Stroke: The Lipid Paradox\",\"authors\":\"Ming-Ya Luo, Fu-Liang Zhang, Shan Lv, Yu Song, Yao Yu, Zhen-Ni Guo, Yi Yang\",\"doi\":\"10.1155/ane/1668467\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>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).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>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, <i>p</i> = 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 (<i>p</i> = 0.041).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>A higher HDL-C level was independently associated with a 3-month unfavorable outcome in IVT-treated patients with AIS. 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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).
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.