Lipid profile, statin use, and outcome after intravenous thrombolysis for acute ischaemic stroke

Low cholesterol levels have been associated with an increased risk of haemorrhagic stroke. This study investigated whether lipid levels or prior statin use influence outcome in patients with acute ischaemic stroke treated with IV thrombolysis.

The relation between admission lipid levels or statin use and both the development of symptomatic intracerebral haemorrhage (sICH) and 3-months functional outcome was assessed in a prospective hospital-based stroke registry comprising 252 patients treated with IV tissue plasminogen activator (tPA). The fasting status of the patients was unknown. Favourable outcome at 3 months was defined as a modified Rankin scale score

Low density lipoprotein (LDL), total cholesterol levels, and statin use were not associated with sICH. Mean triglyceride levels were significantly higher (2.5 mmol/L vs 1.8 mmol/L, p = 0.02) and high density lipoprotein (HDL) was significantly lower (1.0 mmol/L vs 1.2 mmol/L, p = 0.03) in patients with sICH than in patients without sICH. Multivariable analysis showed that higher triglyceride levels were independently associated with sICH (OR 2.16 per mmol/ L increase, 95 % CI 1.20-3.91, p = 0.01). There was no relation between any of the lipid levels or statin use and functional outcome at 3 months.

High admission triglyceride levels were independently associated with a higher risk of sICH, but were not associated with a reduced chance of a favourable functional outcome at 3 months. Total cholesterol levels, LDL levels and statin use had no influence on both the occurrence of sICH or functional outcome.