Cheng Yuan, Wang Qingqing, Niu Guihong, Luo Chun
Medical School, Fuyang Normal University, Fuyang, Anhui, People's Republic of China.
Department of Neurology, The Affiliated Fuyang People's Hospital of Anhui Medical University, Fuyang, Anhui, People's Republic of China.
Int J Gen Med. 2023 May 2;16:1621-1629. doi: 10.2147/IJGM.S407971. eCollection 2023.
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.
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.
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).
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.
动脉粥样硬化性血脂异常（AD）与心血管疾病和中风事件风险增加相关，但AD在接受静脉溶栓治疗的急性缺血性中风（AIS）患者中的作用尚不清楚。本研究旨在探讨AD与接受静脉溶栓治疗的AIS患者长期中风复发之间的关系。
这项前瞻性队列研究纳入了499例接受静脉溶栓治疗的AIS患者。根据急性中风治疗中ORG 10172试验（TOAST）标准、患者临床特征以及多项诊断测试结果对中风亚型进行分类。主要终点事件为缺血性中风复发；使用Kaplan-Meier分析估计首次AIS复发时间，并使用双侧对数秩检验进行比较。采用Cox单因素和多因素回归分析评估AD与长期中风复发之间的关联。
在499例接受rt-PA静脉溶栓治疗的AIS患者中，80例（16.0%）患有AD，60例（12.0%）发生了中风复发事件。Kaplan-Meier分析显示，AD患者的中风复发率显著高于无AD患者（p = 0.035，对数秩检验）以及大动脉疾病（LAD）亚型患者（p = 0.006，对数秩检验）。多因素Cox回归分析显示，AD（HR = 2.363，95%CI：1.294 - 4.314，P = 0.005）和心房颤动（HR = 2.325，95%CI：1.007 - 5.366，P = 0.048）与接受静脉溶栓治疗的AIS患者长期中风复发风险增加相关。此外，AD与LAD亚型接受静脉溶栓治疗患者的中风复发风险增加相关（HR = 3.122，95%CI：1.304 - 7.437，P = 0.011）。
我们发现AD会增加接受静脉溶栓治疗的AIS患者长期中风复发的风险。这种关联在LAD亚型中可能更强。
