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2000
Volume 22, Issue 3
  • ISSN: 1567-2026
  • E-ISSN: 1875-5739

Abstract

Introduction

This study aims to investigate the effect of the serum Total Cholesterol (TC) to High-Density Lipoprotein cholesterol (HDL) ratio (T/H ratio) on Hemorrhagic Transformation (HT) after Intravenous Thrombolysis (IVT) in patients with Acute Cerebral Infarction (ACI).

Methods

Patients with ACI who received alteplase were enrolled. Subgroups were classified based on the occurrence of hemorrhagic transformation (HT) after intravenous thrombolysis (IVT), whether tirofiban was coadministered, and their 90-day prognosis. The primary observation indicators were HT and the 90-day prognosis. Single-factor and multi-factor analyses were performed to identify independent predictors of HT and prognosis.

Results

Age, TC, and HDL were identified as risk factors for ACI. The T/H ratio and HDL were statistically significant in relation to HT ( < 0.05). A correlation was observed between the T/H ratio and HT, with HT more likely to occur when the T/H ratio was greater than or equal to 3.25. The use of tirofiban after IVT did not increase the risk of HT. Significant differences were observed in HT, type of HT, age, hypertension, baseline National Institutes of Health Stroke Scale (NIHSS) score, platelet volume distribution width, TC, D-dimer, and fibrinogen degradation products between groups with different prognoses.

Discussion

The T/H ratio was statistically associated with HT-ACI and predicted HT-ACI to some extent. However, the study had two limitations: the small sample size and the assessment of prognosis through follow-up phone calls, which affected the final results.

Conclusion

Patients with ACI undergoing IVT who had higher baseline NIHSS scores, lower TC, higher HDL, and a higher T/H ratio were at increased risk of HT, which was also associated with long-term outcomes. The T/H ratio may be a valuable predictor of HT following IVT.

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2025-08-29
2026-03-02
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References

  1. WuS W B. Stroke in China: Advances and challenges in epidemiology, prevention, and management.Lancet Neurol.201918439440510.1016/S1474‑4422(18)30500‑3 30878104
    [Google Scholar]
  2. BenjaminE.J. MuntnerP. AlonsoA. Heart disease and stroke statistics—2019 Update: A report from the American heart association.Circulation201913910e56e52810.1161/CIR.0000000000000659 30700139
    [Google Scholar]
  3. LiA. WangH. ZhangL. A single-cell RNA-seq dataset describing macrophages in NSCLC tumor and peritumor tissues.Sci. Data2024111106410.1038/s41597‑024‑03885‑x 39353975
    [Google Scholar]
  4. ZubairA.S. ShethK.N. Hemorrhagic conversion of acute ischemic stroke.Neurotherapeutics202320370571110.1007/s13311‑023‑01377‑1 37085684
    [Google Scholar]
  5. MistryE.A. YeattsS.D. KhatriP. National institutes of health stroke scale as an outcome in stroke research: Value of ANCOVA over analyzing change from baseline.Stroke2022534e150e15510.1161/STROKEAHA.121.034859 35012328
    [Google Scholar]
  6. KnottM. HoelterP. HockS. Can flat-detector CT after successful endovascular treatment predict long-term outcome in patients with large vessel occlusion? An Alberta Stroke Programme Early CT Score–based study.Neurol. Sci.20234441193120010.1007/s10072‑022‑06511‑z 36435896
    [Google Scholar]
  7. DesillesJ.P. MeseguerE. LabreucheJ. Diabetes mellitus, admission glucose, and outcomes after stroke thrombolysis: A registry and systematic review.Stroke20134471915192310.1161/STROKEAHA.111.000813 23704108
    [Google Scholar]
  8. YoonJ.A. ShinY.I. KimD.Y. Post-stroke hyperglycemia in non-diabetic ischemic stroke is related with worse functional outcome: A cohort study.Ann. Rehabil. Med.202145535936710.5535/arm.21124 34743479
    [Google Scholar]
  9. SwarowskaM. PolczakA. PeraJ. Klimkowicz-MrowiecA. SlowikA. DziedzicT. Hyperfibrinogenemia predicts long-term risk of death after ischemic stroke.J. Thromb. Thrombolysis201438451752110.1007/s11239‑014‑1122‑1 25106735
    [Google Scholar]
  10. LvG. WangG. XiaZ. Influences of blood lipids on the occurrence and prognosis of hemorrhagic transformation after acute cerebral infarction: A case-control study of 732 patients.Mil. Med. Res.201961210.1186/s40779‑019‑0191‑z 30665465
    [Google Scholar]
  11. SaverJ.L. ChaisinanunkulN. CampbellB.C.V. Standardized nomenclature for modified rankin scale global disability outcomes: Consensus recommendations from stroke therapy academic industry roundtable XI.Stroke20215293054306210.1161/STROKEAHA.121.034480 34320814
    [Google Scholar]
  12. WilliamsM. PatilS. ToledoE.G. VannemreddyP. Management of acute ischemic stroke: Current status of pharmacological and mechanical endovascular methods.Neurol. Res.200931880781510.1179/016164109X12445505689562 19723449
    [Google Scholar]
  13. RuanG. YingLv. Changes in the level of serum total cholesterol to high-density lipoprotein ratio in acute cerebral infarction.J Bengbu Med Coll2013381216611662
    [Google Scholar]
  14. HoB.L. ChenC.F. LinR.T. LiuC.K. ChaoA.C. Clinical implication of hemorrhagic transformation in ischemic stroke patients treated with recombinant tissue plasminogen activator.Neurol. Sci.201637111799180510.1007/s10072‑016‑2667‑x 27423451
    [Google Scholar]
  15. FiorelliM. BastianelloS. von KummerR. Hemorrhagic transformation within 36 hours of a cerebral infarct: Relationships with early clinical deterioration and 3-month outcome in the European Cooperative Acute Stroke Study I (ECASS I) cohort.Stroke199930112280228410.1161/01.STR.30.11.2280 10548658
    [Google Scholar]
  16. KaesmacherJ. KaesmacherM. MaegerleinC. Hemorrhagic transformations after thrombectomy: Risk factors and clinical relevance.Cerebrovasc. Dis.2017435-629430410.1159/000460265 28343220
    [Google Scholar]
  17. GaoL. ZhangS. WoX. ShenX. TianQ. WangG. Intravenous thrombolysis with alteplase in the treatment of acute cerebral infarction.Pak. J. Med. Sci.202238349850410.12669/pjms.38.3.4521 35480520
    [Google Scholar]
  18. PaciaroniM. AgnelliG. CoreaF. Early hemorrhagic transformation of brain infarction: Rate, predictive factors, and influence on clinical outcome: Results of a prospective multicenter study.Stroke20083982249225610.1161/STROKEAHA.107.510321 18535273
    [Google Scholar]
  19. ZhangX. PatelA. HoribeH. Cholesterol, coronary heart disease, and stroke in the Asia Pacific region.Int. J. Epidemiol.200332456357210.1093/ije/dyg106 12913030
    [Google Scholar]
  20. BaigentC. BlackwellL. EmbersonJ. Efficacy and safety of more intensive lowering of LDL cholesterol: A meta-analysis of data from 170 000 participants in 26 randomised trials.Lancet201037697531670168110.1016/S0140‑6736(10)61350‑5 21067804
    [Google Scholar]
  21. WangX. DongY. QiX. Cholesterol levels and risk of hemorrhagic stroke: A systematic review and meta-analysis.Stroke20134471833183910.1161/STROKEAHA.113.001326 23704101
    [Google Scholar]
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