scholarly journals Serum lipid level is not associated with symptomatic intracerebral hemorrhage after intravenous thrombolysis for acute ischemic stroke

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e6021 ◽  
Author(s):  
Ting-Chun Lin ◽  
Yen-Kuang Lin ◽  
Chin-I Chen ◽  
Lung Chan ◽  
Nai-Fang Chi ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Total Cholesterol ◽  
Functional Outcomes ◽  
Serum Lipid ◽  
Density Lipoprotein ◽  
Intravenous Thrombolysis ◽  
Lipid Levels ◽  
Nihss Score ◽  
Symptomatic Intracerebral Hemorrhage

Background This study assessed whether serum lipid levels are associated with the risk of symptomatic intracerebral hemorrhage (sICH) and functional outcomes in patients with acute ischemic stroke after receiving intravenous thrombolysis. Methods We retrospectively analyzed consecutive ischemic stroke patients who were treated with intravenous tissue plasminogen activator between January 2007 and January 2017. Lipid levels on admission, including total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride levels, as well as potential predictors of sICH were tested using univariate and multivariate analyses. Results Of the 229 enrolled patients (100 women, aged 68 ± 13 years), 14 developed sICH and 103 (45%) had favorable functional outcomes at 3 months. The patients with sICH more often had diabetes mellitus (71% vs. 26%, P = 0.01) and had more severe stroke (mean National Institutes of Health Stroke Scale [NIHSS] score of 16 vs. 13, P = 0.045). Regarding lipid subtype, total cholesterol, LDL-C, HDL-C, and triglyceride levels were not associated with sICH or functional outcomes. According to the results of multivariate analysis, the frequency of sICH was independently associated with diabetes mellitus (odds ratio [OR] = 6.04; 95% CI [1.31–27.95]; P = 0.02) and the NIHSS score (OR = 1.12; 95% CI [1.02–1.22]; P = 0.01). A higher NIHSS score was independently associated with unfavorable functional outcomes (OR = 0.86; 95% CI [0.81–0.91]; P < 0.001). Conclusions Serum lipid levels on admission, including total cholesterol, LDL-C, HDL-C, and triglyceride levels, were not associated with sICH or 3-month functional outcomes after intravenous thrombolysis for acute ischemic stroke.

scholarly journals Thrombolysis in acute ischemic stroke in patients with dementia

Neurology ◽  
2017 ◽  
Vol 89 (18) ◽  
pp. 1860-1868 ◽  
Author(s):  
Eva Zupanic ◽  
Mia von Euler ◽  
Ingemar Kåreholt ◽  
Beatriz Contreras Escamez ◽  
Johan Fastbom ◽  
...  
Keyword(s):  
Cohort Study ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Outcomes ◽  
Intravenous Thrombolysis ◽  
Modified Rankin Scale ◽  
Younger Patients ◽  
Everyday Activities ◽  
Symptomatic Intracerebral Hemorrhage ◽  
To Receive

Objective:To compare access to intravenous thrombolysis (IVT) for acute ischemic stroke (AIS) and its outcomes in patients with and without dementia.Methods:This was a longitudinal cohort study of the Swedish dementia and stroke registries. Patients with preexisting dementia who had AIS from 2010 to 2014 (n = 1,356) were compared with matched patients without dementia (n = 6,755). We examined access to thrombolysis and its outcomes at 3 months (death, residency, and modified Rankin Scale [mRS] score). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated with logistic and ordinal logistic regression.Results:The median age at stroke onset was 83 years in both groups. IVT was administered to 94 (7.0%) patients with dementia and 639 (9.5%) patients without dementia. The OR of receiving IVT was 0.68 (95% CI 0.54–0.86) for patients with dementia. When the analysis was repeated exclusively among patients independent in everyday activities, dementia status was no longer significant (OR 0.79, 95% CI 0.60–1.06). However, differences persisted in patients ≤80 years of age (OR 0.58, 95% CI 0.36–0.94). In patients who received thrombolysis, the incidence of symptomatic intracerebral hemorrhage (sICH; 7.4% vs 7.3%) and death at 3 months (22.0% vs 18.8%) did not differ significantly between the 2 groups. However, mRS score and accommodation status were worse among patients with dementia after 3 months in adjusted analyses (both p < 0.001). Unfavorable outcomes with an mRS score of 5 to 6 were doubled in patients with dementia (56.1% vs 28.1%).Conclusions:Younger patients with dementia and AIS are less likely to receive IVT. Among patients receiving thrombolysis, there are no differences in sICH or death, although patients with dementia have worse accommodation and functional outcomes at 3 months.

scholarly journals Treatment with Delipid Extracorporeal Lipoprotein Filter from Plasma after Intravenous Thrombolysis for Acute Ischemic Stroke: A Single-Center Experience

2020 ◽  
Vol 10 (3) ◽  
pp. 148-158
Author(s):  
Yu Cui ◽  
Zhong-He Zhou ◽  
Xiao-Wen Hou ◽  
Hui-Sheng Chen
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Intravenous Thrombolysis ◽  
Single Center Experience ◽  
Before And After ◽  
Prospective Trials ◽  
Symptomatic Intracranial Hemorrhage ◽  
Rate Of Improvement

<b><i>Introduction:</i></b> The delipid extracorporeal lipoprotein filter from plasma (DELP) has been approved for the treatment of acute ischemic stroke (AIS) by the China Food and Drug Administration, but its effectiveness and mechanism are not yet fully determined. The purpose of this study was to evaluate the effect of DELP treatment on AIS patients after intravenous thrombolysis. <b><i>Methods:</i></b> A retrospective study was performed on AIS patients with no improvement within 24 h after intravenous thrombolysis who were subsequently treated with or without DELP. Primary outcome was the proportion with a modified Rankin scale (mRS) of 0–1 at 90 days. Secondary outcomes were changes in National Institute of Health Stroke Scale (NIHSS) score from 24 h to 14 days after thrombolysis, and the rate of improvement in stroke-associated pneumonia (SAP). The main safety outcomes were the rates of symptomatic intracranial hemorrhage and mortality. To investigate its mechanisms, serum biomarkers were measured before and after DELP. <b><i>Results:</i></b> A total of 252 patients were recruited, 63 in the DELP group and 189 matched patients in the NO DELP group. Compared with the NO DELP group, the DELP group showed an increase in the proportion of mRS 0–1 at 90 days (<i>p</i> = 0.042). More decrease in NIHSS from 24 h to 14 days (<i>p</i> = 0.024), a higher rate of improvement in SAP (<i>p</i> = 0.022), and lower mortality (<i>p</i> = 0.040) were shown in DELP group. Furthermore, DELP decreased levels of interleukin (IL)-1β, E-selectin, malondialdehyde, matrix metalloprotein 9, total cholesterol, low-density lipoprotein, and fibrinogen, and increased superoxide dismutase (<i>p</i>&#x3c; 0.05). <b><i>Conclusions:</i></b> DELP following intravenous thrombolysis should be safe, and is associated with neurological function improvement, possibly through multiple neuroprotective mechanisms. Prospective trials are needed.

scholarly journals PSV-15 Influence of the temperament of water buffaloes on the serum lipid levels

2020 ◽  
Vol 98 (Supplement_4) ◽  
pp. 221-222
Author(s):  
Caroline L Francisco ◽  
André M Castilhos ◽  
Daiane C Marques da Silva ◽  
Fabiola Martinez da Silva ◽  
Aline S Aranha ◽  
...  
Keyword(s):  
Total Cholesterol ◽  
Repeated Measures ◽  
Serum Lipid ◽  
Fixed Effects ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Low Density ◽  
Lipid Levels ◽  
Water Buffaloes ◽  
Serum Lipid Levels

Abstract This study evaluated the effect of the temperament of 75 water buffaloes of three genetic groups (GG: Jafarabadi, Mediterranean, and Murrah; n = 25 for each GG) on serum lipid levels. The animals were classified for temperament through the temperament score (TSc) obtained by the mean of the sum of the scores of the entry time into the squeeze chute (1 to 5: 1=greater time spent for entry, and 5=less time spent for entry) and the exit velocity score (1 to 5: 1=lower speed, and 5=higher speed) calculated after the period of adaptation to the feedlot (d0). The animals were categorized into adequate (ADQ; TSc≤3) or excitable (EXC; TSc &gt;3) temperaments. Blood samples were collected from the jugular vein on days -28, 0, and 84, and evaluated for serum levels of total cholesterol, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL) using colorimetric enzymatic analyses performed by commercial kits. Data were analyzed using MIXED procedure in SAS, considering the GG, temperament, day, and the resulting interactions as fixed effects. The term day was used for repeated measures in time. Correlations were estimated using the CORR procedure in SAS. There were no interactions for the variables evaluated (P ≥ 0.11). ADQ animals showed lower levels of total cholesterol (65.95 vs 70.96mg/dL for ADQ and EXC, respectively; SEM=2.33; P = 0.04) and LDL (26.74 vs 30.40mg/dL for ADQ and EXC, respectively; SEM=1.57; P = 0.02) than EXC animals. There was no effect of temperament for the triglycerides (P = 0.41), HDL (P = 0.47), and VLDL (P = 0.46). Positive correlations were verified between both the TSc and triglycerides (r=0.32; P &lt; 0.01), and TSc and VLDL (r=0.33; P &lt; 0.01). Tendency for a positive correlation was detected between TSc and LDL (r=0.20; P = 0.09). In conclusion, there are differences in serum lipid levels between water buffalo temperaments which deserves further investigation. Supported by FAPESP (#2018/25939-1; #2014/05473-7).

scholarly journals Clinical profile of patients with acute ischemic stroke receiving intravenous thrombolysis (rtPA-alteplase)

2018 ◽  
Vol 5 (1) ◽  
pp. 164
Author(s):  
Shiva Prasad Jagini ◽  
Suresh I.
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Prospective Observational Study ◽  
Primary Outcome ◽  
Intravenous Thrombolysis ◽  
Clinical Profile ◽  
Favorable Outcome ◽  
Nihss Score ◽  
The Mean ◽  
Centre Hospital

Background: Stroke patients are at highest risk death in the first few weeks after the event, and between 20-50% die within first month depending on type, severity, age, co-morbidities and effectiveness of treatment of complications. Objective of this study was to clinical profile of patients with acute ischemic stroke receiving intravenous thrombolysis (rtPA-alteplase).Methods: Prospective Observational study of 26 cases of acute ischemic stroke receiving IV thrombolysis using rtPA-alteplase at Kovai Medical Centre Hospital, Coimbatore over a period of 1 year 9 months.Results: 21 cases had NIHSS score of range 10 to 22. The mean NIHSS score at admission is 13.5. 15 subjects (57.7%) had achieved primary outcome in this study. MRS Score of 0 to 2 is considered as favorable outcome. In this study 20 subjects (76.92 %) had favorable outcome at the end of 3 months.Conclusions: Majority of the patients receiving rtPA-alteplase had favorable outcome.

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