• Noriko Makihara, Yasushi Okada, Masatoshi Koga, Yoshiaki Shiokawa, Jyoji Nakagawara, Eisuke Furui, Kazumi Kimura, Hiroshi Yamagami, Yasuhiro Hasegawa, Kazuomi Kario, Satoshi Okuda, Masaki Naganuma, and Kazunori Toyoda.
• Department of Cerebrovascular Medicine, Cerebrovascular Center and Clinical Research Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
• Cerebrovasc. Dis. 2012 Jan 1; 33 (3): 240-7.

BackgroundThe effects of lipid levels on clinical outcomes after ischemic stroke are controversial. Whether admission lipid levels and prior statin use are associated with early intracerebral hemorrhage (ICH) and long-term functional outcome after recombinant tissue plasminogen activator (rt-PA) therapy for stroke patients was investigated.MethodsIschemic stroke patients who received intravenous rt-PA from a multicenter registry were studied. Lipid levels on admission, including total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, and triglyceride levels, as well as prior statin use, were assessed. The primary outcome was favorable outcome at 3 months corresponding to a modified Rankin Scale score ≤1. The secondary outcome was any or symptomatic ICH within the initial 36 h.ResultsOf 489 enrolled patients (171 women, 70.8 ± 11.6 years old), 60 used statins prior to stroke, 93 developed ICH (19.0%), and 188 (38.4%) had a favorable 3-month outcome. Of the lipid levels, only the HDL-C level was an independent predictor of favorable outcome after multivariate adjustment for baseline characteristics (OR 1.95, 95% CI 1.10-3.47 per 1 mmol/l; p = 0.023) and after further adjustment for pretreatment radiological findings (OR 2.03, 95% CI 1.07-3.84; p = 0.029). For the 187 stroke patients without cardioembolism, the HDL-C level was more strongly associated with favorable outcome (OR 4.94, 95% CI 1.91-12.76 per 1 mmol/l; p = 0.001). There were no significant associations between ICH and any lipid levels. Prior statin use was not associated with outcomes.ConclusionsThe admission HDL-C level was associated with favorable outcome 3 months after intravenous rt-PA therapy in stroke patients without cardioembolism.Copyright © 2012 S. Karger AG, Basel.

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