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

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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

Issue Date
2022-09
Publisher
Nature Publishing Group
Citation
Scientific Reports, Vol.12 No.1, p. 15478
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 (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.
ISSN
2045-2322
URI
https://hdl.handle.net/10371/186556
DOI
https://doi.org/10.1038/s41598-022-19852-8
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