Abstract T P21: Improved Ischemic Stroke Outcomes After Intra-Arterial Interventions Associated With Higher HDL Cholesterol

Abstract

Background/Objective: The effect of pre-morbid lipid levels on neurologic outcome after Acute Ischemic Stroke (AIS) is variable in the published literature. In this study, we retrospectively use a cohort to evaluate the relationship of cholesterol subfractions to outcome. Methods: The cohort consists of AIS patients treated with IA therapy between September 2008 and December 2010. Favorable outcome for these analyses was defined as a modified Rankin Scale of ≤ 3 at time of discharge. Univariate associations with favorable outcome were sought for demographic, co-morbidity, stroke risk factor, and procedure related variables. Independent associations were identified by relative risk regression using generalized linear models with a logit link, a Poisson distribution for variance and robust standard errors. All analyses were performed in STATA. Results: The cohort included 42 patients; mean age was 62 years, 62% were women, median pre-procedure NIHSS was 16, 70% of patients achieved a mRS ≤ 3. Univariate analysis suggested significance of a number of variables with favorable outcome. In multivariate analysis only three variables-previous tobacco use, highest procedural SBP, and history of atrial fibrillation-remained significant. Adding LDL to the multivariate model did not show association, though adding HDL as a continuous variable did show an association. Results are shown in the table. Conclusions: In our cohort there was no association between favorable outcome at time of discharge and LDL, but higher HDL was associated with an increased chance of good outcome. While this association between HDL and outcome is reported for patients treated with intravenous tPA, it is novel for patients treated with IA therapy and warrants further study. Our data collection is ongoing and we aim to double the size of our dataset; the updated analyses will be presented at the meeting.