Association Between Low-density Lipoprotein Cholesterol And Hemorrhagic Transformation After Intravenous Thrombolysis In Patients With Acute Ischemic Stroke

III Objective:This study aims to explore the relationship between low-density lipoprotein cholesterol(LDL-C)and hemorrhage transformation after intravenous thrombolysis in patients with acute ischemic stroke.Methods:This study retrospectively included patients with AIS who came to the hospital within 4.5 hours of hospitalization in the First Hospital of Shanxi Medical University from January 2014 to December 2019.All patients received the standard of recombinant tissue plasminogen activator(rt-PA)Dose(0.9mg/Kg)intravenous thrombolysis,all need to complete the head CT examination within 24 hours to judge the bleeding,compare the demographic data and baseline characteristics of the hemorrhage transformation group and the non-hemorrhage transformation group.Multivariate logistic regression analysis was used to determine the correlation between LDL-C and hemorrhage transformation after thrombolysis.The optimal prediction cutoff point of LDL-C for bleeding after thrombolysis was found by ROC curve.Results:A total of 323 patients with AIS were collected and enrolled in this study.The number of 91 cases(28.17%)developed HT after thrombolysis.Univariate analysis showed that the two groups of patients were statistically different in age,NIHSS score at admission,baseline blood pressure,atrial fibrillation history,LDL-C,prethrombolytic fibrinogen degradation products,D-dimer,and stroke etiology(TOAST classification)Academic significance(all p<0.05).In order to injust the interference of other confounding factors,the results of multivariate logistic regression analysis showed that LDL-C(OR 0.531,95%CI 0.571～3.313,P=0.002),NIHSS score at admission(OR1.063,95%CI 1.010～1.120,P=0.020)and baseline systolic blood pressure(OR 1.015,95%CI 1.004～1.026,P=0.008)were independent risk factors for HT after intravenous thrombolysis in AIS patients(all p<0.05).Conclusion:Low LDL-C level is an independent risk factor for hemorrhage transformation after intravenous thrombolysis in AIS patients.Therefore,patients with low LDL-C level should be cautious about lipid-lowering treatment and be alert to the occurrence of HT.