Document Detail


Impact of statin use and lipid profile on symptomatic intracerebral haemorrhage, outcome and mortality after intravenous thrombolysis in acute stroke.
MedLine Citation:
PMID:  22433177     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: It is unclear if a certain lipid profile and/or statin use contribute to symptomatic intracerebral haemorrhage (sICH), poor outcome or mortality after intravenous thrombolysis for ischaemic stroke. The aim of the current study was to assess the impact of statin use and lipid profile on sICH, outcome and mortality following thrombolysis in acute stroke.
METHODS: From 2001 to 2010, all patients admitted to our hospital and undergoing intravenous thrombolysis for acute ischaemic stroke were included into an open, prospective database. Initial stroke severity was assessed using the National Institute of Health Stroke Scale. Demographics, vascular risk factors, admission blood pressure, glucose levels, previous medication including statin use, lipid profiles including low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglyceride levels were recorded. Outcome measures included sICH according to the European Cooperative Acute Stroke Study II criteria, modified Rankin scale and mortality at 3 months.
RESULTS: 1,066 patients were included in the analysis; 5.3% (57 patients) had sICH. Mortality at 3 months was 17.6% (188 patients). A favourable outcome (modified Rankin scale 0-1) at 3 months was attained by 35.6% (379 patients). Prior statin use was not associated with increased odds for sICH (OR 1.05, 95% CI 0.55-2.04, p = 0.864), mortality (OR 1.32, 95% CI 0.90-1.93, p = 0.152) or favourable outcome (OR 0.89, 95% CI 0.65-1.24, p = 0.507). Similar results were found for the different lipid variables: high LDL (OR 0.96, 95% CI 0.36-2.60, p = 0.942), high triglyceride (OR 1.74, 95% CI 0.84-3.56, p = 0.132) and low HDL (OR 1.78, 95% CI 0.68-4.65, p = 0.279) were not associated with increased odds for sICH. Likewise, neither mortality nor functional outcome at 3 months was significantly associated with any of the lipid variables in the univariable analysis following Bonferroni adjustment for multiple comparisons. The same results were found in the multivariable analysis adjusting for imbalances in baseline characteristics.
CONCLUSIONS: In contrast to previous studies, we found that in stroke patients receiving thrombolysis therapy, neither the lipid profile nor prior statin use were associated with increased odds for sICH, functional outcome or mortality at 3 months.
Authors:
Andrea Rocco; Marek Sykora; Peter Ringleb; Jennifer Diedler
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Publication Detail:
Type:  Journal Article     Date:  2012-03-14
Journal Detail:
Title:  Cerebrovascular diseases (Basel, Switzerland)     Volume:  33     ISSN:  1421-9786     ISO Abbreviation:  Cerebrovasc. Dis.     Publication Date:  2012  
Date Detail:
Created Date:  2012-04-27     Completed Date:  2012-07-26     Revised Date:  2012-11-21    
Medline Journal Info:
Nlm Unique ID:  9100851     Medline TA:  Cerebrovasc Dis     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  362-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 S. Karger AG, Basel.
Affiliation:
Department of Neurology, University of Heidelberg, Heidelberg, Germany. Andrea.Rocco@med.uni-heidelberg.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Pressure / physiology
Brain Ischemia / complications
Cerebral Hemorrhage / mortality*,  therapy*
Cholesterol, HDL / blood
Cholesterol, LDL / blood
Databases, Factual
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
Lipids / blood*
Male
Risk Factors
Stroke / drug therapy*,  mortality*
Thrombolytic Therapy*
Tomography, X-Ray Computed
Treatment Outcome
Triglycerides / blood
Chemical
Reg. No./Substance:
0/Cholesterol, HDL; 0/Cholesterol, LDL; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Lipids; 0/Triglycerides
Comments/Corrections
Comment In:
Expert Rev Neurother. 2012 Aug;12(8):907-10   [PMID:  23002934 ]

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