Differential influences of LDL cholesterol on functional outcomes after intravenous thrombolysis according to prestroke statin use

• Published in: Scientific reports Vol. 12; no. 1; p. 15478
• Main Authors: Kang, You-Ri, Kim, Joon-Tae, Lee, Ji Sung, Kim, Beom Joon, Kang, Kyusik, Lee, Soo Joo, Kim, Jae Guk, Cha, Jae-Kwan, Kim, Dae-Hyun, Park, Tai Hwan, Lee, Kyung Bok, Lee, Jun, Hong, Keun-Sik, Cho, Yong-Jin, Park, Hong-Kyun, Lee, Byung-Chul, Yu, Kyung-Ho, Oh, Mi Sun, Kim, Dong-Eog, Ryu, Wi-Sun, Choi, Jay Chol, Kwon, Jee-Hyun, Kim, Wook-Joo, Shin, Dong-Ick, Sohn, Sung Il, Hong, Jeong-Ho, Park, Man-Seok, Choi, Kang-Ho, Cho, Ki-Hyun, Park, Jong-Moo, Lee, Sang-Hwa, Lee, Juneyoung, Bae, Hee-Joon
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 14.09.2022; Nature Publishing Group; Nature Portfolio
• Subjects: 692/617; 692/617/375; 692/617/375/534; Aged; Cholesterol; Cholesterol, LDL; Humanities and Social Sciences; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Intravenous administration; Ischemia; Ischemic Stroke; Low density lipoprotein; Male; Middle Aged; multidisciplinary; Patients; Science; Science (multidisciplinary); Statins; Stroke - drug therapy; Thrombolysis; Thrombolytic Therapy
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-022-19852-8

This study aimed to elucidate whether low-density lipoprotein cholesterol (LDL-C) levels differentially affect functional outcomes after intravenous thrombolysis (IVT) depending on prestroke statin use. Patients with acute ischemic stroke treated with IVT were categorized into low, intermediate, and high LDL-C groups based on LDL-C levels at admission (< 100/100–130/ > 130 mg/dl, respectively). Multivariable logistic regression analyses were performed to explore the relationships between LDL-C and clinical outcomes (good outcomes at 3 months, modified Rankin Scale scores 0–2). The interaction between LDL-C levels and prestroke statin use regarding functional outcomes was investigated. Among the 4711 patients (age, 67 ± 12 years; males, 62.1%) who met the eligibility criteria, compared with the high LDL-C group, the low and intermediate LDL-C groups were not associated with good outcomes at 3 months according to the multivariable analysis. A potential interaction between the LDL-C group and prestroke statin use on good outcomes at 3 months was observed ( P interaction  = 0.07). Among patients with prestroke statin use, low (aOR 1.84 [1.04–3.26]) and intermediate (aOR 2.31 [1.20–4.47]) LDL-C groups were independently associated with a greater likelihood of having a 3-month good outcome. Our study showed that LDL-C was not associated with a 3-month good outcome, but prestroke statin use could modify the influence of LDL-C levels on functional outcomes after IVT.