Serum lipid level is not associated with symptomatic intracerebral hemorrhage after intravenous thrombolysis for acute ischemic stroke

Ting-Chun Lin; Yen-Kuang Lin; Chin-I Chen; Lung Chan; Nai-Fang Chi; Rey-Yue Yuan; Jau-Jiuan Sheu; Chun-Ren Wei; Jui-Ping Tsai; Tu-Hsueh Yeh

doi:10.7717/peerj.6021

Serum lipid level is not associated with symptomatic intracerebral hemorrhage after intravenous thrombolysis for acute ischemic stroke

PeerJ. 2018 Nov 23:6:e6021. doi: 10.7717/peerj.6021. eCollection 2018.

Authors

Affiliations

¹ Department of Neurology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.
² Research Center of Biostatistics, Taipei Medical University, Taipei, Taiwan.
³ Department of Neurology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
⁴ Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.

Abstract

Background: This study assessed whether serum lipid levels are associated with the risk of symptomatic intracerebral hemorrhage (sICH) and functional outcomes in patients with acute ischemic stroke after receiving intravenous thrombolysis.

Methods: We retrospectively analyzed consecutive ischemic stroke patients who were treated with intravenous tissue plasminogen activator between January 2007 and January 2017. Lipid levels on admission, including total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride levels, as well as potential predictors of sICH were tested using univariate and multivariate analyses.

Results: Of the 229 enrolled patients (100 women, aged 68 ± 13 years), 14 developed sICH and 103 (45%) had favorable functional outcomes at 3 months. The patients with sICH more often had diabetes mellitus (71% vs. 26%, P = 0.01) and had more severe stroke (mean National Institutes of Health Stroke Scale [NIHSS] score of 16 vs. 13, P = 0.045). Regarding lipid subtype, total cholesterol, LDL-C, HDL-C, and triglyceride levels were not associated with sICH or functional outcomes. According to the results of multivariate analysis, the frequency of sICH was independently associated with diabetes mellitus (odds ratio [OR] = 6.04; 95% CI [1.31-27.95]; P = 0.02) and the NIHSS score (OR = 1.12; 95% CI [1.02-1.22]; P = 0.01). A higher NIHSS score was independently associated with unfavorable functional outcomes (OR = 0.86; 95% CI [0.81-0.91]; P < 0.001).

Conclusions: Serum lipid levels on admission, including total cholesterol, LDL-C, HDL-C, and triglyceride levels, were not associated with sICH or 3-month functional outcomes after intravenous thrombolysis for acute ischemic stroke.

Keywords: Ischemic stroke; Lipid; Symptomatic intracerebral hemorrhage; Thrombolysis.

Grants and funding

This study was supported by the Taipei Medical University Hospital (104TMUH-NE-01). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.