Correlation of Atherosclerotic Dyslipidemia with Long-Term Stroke Recurrence in Patients Undergoing Intravenous Thrombolysis for Acute Ischemic Stroke

Abstract

Yuan Cheng,1,* Qingqing Wang,2,* Guihong Niu,1 Chun Luo3 1Medical School, Fuyang Normal University, Fuyang, Anhui, People’s Republic of China; 2Department of Neurology, The Affiliated Fuyang People’s Hospital of Anhui Medical University, Fuyang, Anhui, People’s Republic of China; 3Department of Pediatric Surgery, Fuyang Women and Children’s Hospital, Fuyang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Guihong Niu, Medical School, Fuyang Normal University, Fuyang, Anhui, 236300, People’s Republic of China, Email [email protected] Chun Luo, Department of Pediatric Surgery, Fuyang Women and Children’s Hospital, Fuyang, Anhui, 236300, People’s Republic of China, Email [email protected]: Atherosclerotic dyslipidemia (AD) is associated with an increased risk of cardiovascular diseases and stroke events, but the effect of AD among acute ischemic stroke (AIS) patients undergoing intravenous thrombolysis is unclear. This study aimed to investigate the relationship between AD and long-term stroke recurrence in AIS patients undergoing intravenous thrombolysis.Methods: This prospective cohort study included 499 AIS patients treated with intravenous thrombolysis. Stroke subtype was classified according to the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) criteria, patients’ clinical characteristics, and results from multiple diagnostic tests. The primary endpoint event was ischemic stroke recurrence; the time to first AIS recurrence was estimated using Kaplan‒Meier analysis and compared using the two-sided Log rank test. Cox univariate and multivariate regression analyses were used to assess the association between AD and long-term stroke recurrence.Results: Of the 499 patients with AIS treated with rt-PA intravenous thrombolysis, 80 (16.0%) had AD, and 60 (12.0%) had a stroke recurrence event. Kaplan‒Meier analysis showed that the stroke recurrence rate was significantly higher in patients with AD than in those without AD (p = 0.035, log rank test) and in the large-artery disease (LAD) subtype (p = 0.006, log rank test). Multivariate Cox regression analysis showed that AD (HR = 2.363, 95% CI: 1.294– 4.314, P = 0.005) and atrial fibrillation (HR = 2.325, 95% CI: 1.007– 5.366, P = 0.048) were associated with an increased risk of long-term stroke recurrence in AIS patients who underwent intravenous thrombolysis. Furthermore, AD was associated with an increased risk of stroke recurrence in patients undergoing intravenous thrombolysis in the LAD subtype (HR = 3.122, 95% CI: 1.304– 7.437, P = 0.011).Conclusion: We found that AD increases the risk of long-term stroke recurrence in AIS patients undergoing intravenous thrombolysis. This association may be stronger in the LAD subtype.Keywords: atherosclerotic dyslipidemia, ischemic stroke, stroke recurrence, thrombolysis

Keywords

• atherosclerotic dyslipidemia
• ischemic stroke
• stroke recurrence
• thrombolysis