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SHR Neuro Cancer Cardio Lipid Metab Microb
Pikija, S; Sztriha, LK; Killer-Oberpfalzer, M; Weymayr, F; Hecker, C; Ramesmayer, C; Hauer, L; Sellner, J.
Contribution of Serum Lipid Profiles to Outcome After Endovascular Thrombectomy for Anterior Circulation Ischemic Stroke.
Mol Neurobiol. 2019; 56(6): 4582-4588.
Doi: 10.1007/s12035-018-1391-3
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- Pikija Slaven
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- 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.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged - administration & dosage
- Aged, 80 and over - administration & dosage
- Brain Ischemia - blood, surgery
- Endovascular Procedures - administration & dosage
- Female - administration & dosage
- Humans - administration & dosage
- Hyperlipidemias - blood
- Lipids - blood
- Male - administration & dosage
- Middle Aged - administration & dosage
- Multivariate Analysis - administration & dosage
- Stroke - blood, surgery
- Thrombectomy - administration & dosage
- Treatment Outcome - administration & dosage
- Find related publications in this database (Keywords)
- Ischemic stroke
- Cholesterol
- Low-density lipoprotein
- Thrombectomy
- Outcome