Page 319

Karger_ESC London_2013

London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 319 75 Stroke prognosis High HDL is associated with favorable outcome after ischemic stroke S. Fonville1, P.J. Koudstaal2, H.M. den Hertog3 Erasmus Medical Center, Rotterdam, THE NETHERLANDS1, Erasmus Medical Center, Rotter-dam, THE NETHERLANDS2, Medical Spectre Twente, Enschede, THE NETHERLANDS3 Background Recently, HDL and triglycerides levels have been associated with outcome after stroke. We therefore aimed to confirm this association in an independent cohort and assessed the association between se-rum lipid levels during admission and functional outcome 3 months after ischemic stroke. Methods We evaluated 371 patients with ischemic stroke admitted to the stroke unit or visiting the outpatient clinic in whom lipid profile including total cholesterol, high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), and triglyceride levels, as well as prior statin use, were assessed on day 0-5 after the event. Favorable functional outcome was defined as a score on the mRS of less than 2. The relation between lipid profile and outcome was expressed as odds ratio (OR) with corresponding 95% confidence intervals (CI). Adjustments were made for age, sex, NI-HSS on admission, intravenous rtPA, smoking and other diseases influencing the mRS. Results Of the 371 enrolled patients, 122 (33%) used statins on admission. Hundred seventy-eight (48%) patients had favorable outcome at 3 months. Prior statin use, total cholesterol, LDL and triglyceride levels were comparable between patients with and without favorable outcome. Only HDL levels were significantly higher in patients with favorable outcome compared to those without favorable outcome (resp. 1.38 mmol/L (SD 0.47) and 1.25 mmol/L (SD 0.40), p-value 0.005). High HDL lev-els were independently associated with favorable functional outcome at 3 months (aOR 1.95 (95% CI 1.04-3.66)). Conclusion We confirmed that a high HDL level is an independent prognostic factor for favorable functional outcome after ischemic stroke. However, we could not confirm the association between triglyceride levels and functional outcome. 76 Stroke prognosis Early and Continuous Neurological Improvement after Intravenous Thrombolysis are Strong Predictors of Favorable Long-term Outcome in Acute Ischemic Stroke V.K. Sharma1, H.L. Teoh2, B.P.L. Chan3, R.C. Seet4, B.R. Wakerley5, P.R. Paliwal6, L. Shen7, L.L. Yeo8 National University of Singapore, Singapore, SINGAPORE1, National University Health Sys-tem, Singapore, SINGAPORE2, National University Health System, Singapore, SINGAPORE3, National University of Singapore, Singapore, SINGAPORE4, National University Health System, Singapore, SINGAPORE5, National University Health System, Singapore, SINGAPORE6, National University of Singapore, Singapore, SINGAPORE7, National University Health System, Singapore, SINGAPORE8 Background: Considerable proportion of acute ischemic stroke (AIS) patients demonstrates changes in their neurological status within first 24-hours of intravenous thrombolysis with tissue plasmino-gen activator (IV-tPA). We evaluated the relationship between early neurological improvement and functional outcomes in thrombolysed AIS patients at 3-months. Methods: Data for consecutive AIS patients treated with IV-tPA within 4.5-hours of symptom-onset during 2007-2011 were prospective-ly entered in our thrombolysed registry. National Institute of Health Stroke Scale (NIHSS) scores were recorded before IV-tPA bolus, at 2-hours and at 24-hours. Early neurological improvement at 2-hours (ENI) was defined as reduction in NIHSS by ≥10 points from baseline or an absolute score of ≤4 points at 2-hours. Continuous neurological improvement (CNI) was defined as a reduction of NIHSS score by ≥8 points between 2-hours and 24-hours or absolute score of ≤4 points at 24-hours. Favorable functional outcomes at 3-months were determined by modified Rankin scale (mRS) 0-1. Results: Of the 2460 AIS patients admitted during the study period, 263 (10.7%) received IV-tPA; median age 64years (range 19-92), 63.9% males, median NIHSS 17points (range 3-35) and medi-an onset-to-treatment time 145minutes (range 57-270). Overall, 130 (49.4) thrombolyzed patients achieved mRS 0-1at 3-months. NIHSS at onset (OR per 1-point increase 0.893, 95% CI 0.854- 0.934, p<0.001), ENI-2 (OR 2.836 95% CI 1.436-5.602, p=0.003) and CNI (OR 7.753 95% CI 3.889-15.455, p<0.001) were found to be independent predictors of favorable outcome at 3-months. Conclusion: Early and continuous neurological improvement within first 24-hours is strong predic-tors of favorable functional outcome in thrombolyzed AIS patients.


Karger_ESC London_2013
To see the actual publication please follow the link above