Low level of low-density lipoprotein cholesterol increases hemorrhagic transformation in large artery atherothrombosis but not in cardioembolism

Beom Joon Kim, Seung Hoon Lee, Wi Sun Ryu, Bong Su Kang, Chi Kyung Kim, Byung Woo Yoon

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Background and Purpose-: Low cholesterol level is known to be associated with increased cerebral hemorrhage. However, the associations of hemorrhagic transformation (HTf) after acute ischemic stroke and the low levels of total cholesterol (TC) or low-density lipoprotein cholesterol (LDLC) are largely undiscovered. Methods-: Of the 1034 patients with acute ischemic stroke who were consecutively admitted to our hospital, 377 patients with stroke attributable to large artery atherothrombosis (LAA; n=210) or cardioembolism (n=167) were selected for this study. Demographic and clinical information was collected and HTf was evaluated through follow-up T2*-weighted gradient-echo MRI performed usually within 1 week after stroke. Measurement of lipid parameters included TC, LDLC, high-density lipoprotein cholesterol, and triglyceride. Results-: Of the 377 patients, HTf was noted in 74 patients (19.6%). When patients were divided into 4 groups according to their TC and LDLC levels, the incidence of HTf was significantly elevated in the lowest quartile of each TC (P<0.01) and LDLC (P<0.01) level in LAA subgroup, but not in cardioembolism. After adjusting covariates, a low level of LDLC (OR, 0.46 per 1 mmol/L-increase; 95% CI, 0.22-0.98) was independently associated with HTf in LAA, but not in cardioembolism. There was no significant association between low levels of TC (OR, 0.63 per 1 mmol/L-increase; 95% CI, 0.35-1.15) and HTf in LAA. Conclusions-: Low levels of LDLC, and possibly TC, are associated with greater risk of hemorrhagic transformation after acute ischemic stroke attributable to LAA.

Original languageEnglish
Pages (from-to)1627-1632
Number of pages6
JournalStroke
Volume40
Issue number5
DOIs
Publication statusPublished - 2009 May 1
Externally publishedYes

Fingerprint

LDL Cholesterol
Arteries
Cholesterol
Stroke
Cerebral Hemorrhage
HDL Cholesterol
Demography
Lipids
Incidence

Keywords

  • Cholesterol
  • Hemorrhagic
  • Ischemic stroke
  • Low-density lipoprotein cholesterol
  • Neurovascular unit
  • Transformation

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialised Nursing

Cite this

Low level of low-density lipoprotein cholesterol increases hemorrhagic transformation in large artery atherothrombosis but not in cardioembolism. / Kim, Beom Joon; Lee, Seung Hoon; Ryu, Wi Sun; Kang, Bong Su; Kim, Chi Kyung; Yoon, Byung Woo.

In: Stroke, Vol. 40, No. 5, 01.05.2009, p. 1627-1632.

Research output: Contribution to journalArticle

Kim, Beom Joon ; Lee, Seung Hoon ; Ryu, Wi Sun ; Kang, Bong Su ; Kim, Chi Kyung ; Yoon, Byung Woo. / Low level of low-density lipoprotein cholesterol increases hemorrhagic transformation in large artery atherothrombosis but not in cardioembolism. In: Stroke. 2009 ; Vol. 40, No. 5. pp. 1627-1632.
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AU - Kim, Beom Joon

AU - Lee, Seung Hoon

AU - Ryu, Wi Sun

AU - Kang, Bong Su

AU - Kim, Chi Kyung

AU - Yoon, Byung Woo

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AB - Background and Purpose-: Low cholesterol level is known to be associated with increased cerebral hemorrhage. However, the associations of hemorrhagic transformation (HTf) after acute ischemic stroke and the low levels of total cholesterol (TC) or low-density lipoprotein cholesterol (LDLC) are largely undiscovered. Methods-: Of the 1034 patients with acute ischemic stroke who were consecutively admitted to our hospital, 377 patients with stroke attributable to large artery atherothrombosis (LAA; n=210) or cardioembolism (n=167) were selected for this study. Demographic and clinical information was collected and HTf was evaluated through follow-up T2*-weighted gradient-echo MRI performed usually within 1 week after stroke. Measurement of lipid parameters included TC, LDLC, high-density lipoprotein cholesterol, and triglyceride. Results-: Of the 377 patients, HTf was noted in 74 patients (19.6%). When patients were divided into 4 groups according to their TC and LDLC levels, the incidence of HTf was significantly elevated in the lowest quartile of each TC (P<0.01) and LDLC (P<0.01) level in LAA subgroup, but not in cardioembolism. After adjusting covariates, a low level of LDLC (OR, 0.46 per 1 mmol/L-increase; 95% CI, 0.22-0.98) was independently associated with HTf in LAA, but not in cardioembolism. There was no significant association between low levels of TC (OR, 0.63 per 1 mmol/L-increase; 95% CI, 0.35-1.15) and HTf in LAA. Conclusions-: Low levels of LDLC, and possibly TC, are associated with greater risk of hemorrhagic transformation after acute ischemic stroke attributable to LAA.

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KW - Hemorrhagic

KW - Ischemic stroke

KW - Low-density lipoprotein cholesterol

KW - Neurovascular unit

KW - Transformation

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