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

You Ri Kang, Joon Tae Kim, Ji Sung Lee, Beom Joon Kim, Kyusik Kang, Soo Joo Lee, Jae Guk Kim, Jae Kwan Cha, Dae Hyun Kim, Tai Hwan Park, Kyung Bok Lee, Jun Lee, Keun Sik Hong, Yong Jin Cho, Hong Kyun Park, Byung Chul Lee, Kyung Ho Yu, Mi Sun Oh, Dong Eog Kim, Wi Sun RyuJay Chol Choi, Jee Hyun Kwon, Wook Joo Kim, Dong Ick Shin, Sung Il Sohn, Jeong Ho Hong, Man Seok Park, Kang Ho Choi, Ki Hyun Cho, Jong Moo Park, Sang Hwa Lee, Juneyoung Lee, Hee Joon Bae

Research output: Contribution to journalArticlepeer-review

Abstract

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 (Pinteraction = 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.

Original languageEnglish
Article number15478
JournalScientific Reports
Volume12
Issue number1
DOIs
StatePublished - Dec 2022
Externally publishedYes

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