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Low-density lipoprotein level on admission is not associated with postintravenous thrombolysis intracranial hemorrhage in patients with acute ischemic stroke
  1. Chien Tai Hong1,2,3,
  2. Wei Ting Chiu1,2,3,
  3. Nai Fang Chi1,3,
  4. Le Yan Lai1,3,
  5. Chaur Jong Hu1,2,3,4,
  6. Han Hwa Hu1,2,3,
  7. Lung Chan1,2,3
  1. 1 Department of Neurology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
  2. 2 Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
  3. 3 Stroke Centre, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
  4. 4 Graduate Institute of Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
  1. Correspondence to Dr Lung Chan, Department of Neurology, Shuang Ho Hospital, Taipei Medical University, Taipei 23561, Taiwan; cjustinmd{at}


Intravenous thrombolysis with the tissue plasminogen activator (tPA) is the gold standard for acute ischemic stroke. However, its application is limited because of the concern of the post-tPA intracranial hemorrhage (ICH). Low low-density lipoprotein (LDL) has been speculated to increase the risk of hemorrhagic transformation after ischemic stroke. However, whether LDL is associated with post-tPA ICH remains controversial. The present study obtained the medical records from Shuang Ho Hospital and retrospectively reviewed for the period between August 2009 and December 2016 to investigate the association between LDL and the risk of post-tPA ICH. The differences were analyzed using the Student’s t-test, Fisher’s exact test, the univariate and stepwise multiple regression model, and p<0.05 was considered statistically significant. Among 218 patients, post-tPA ICH was noted in 23 (10.5%) patients. Patients with post-tPA ICH tended to have a lower LDL level (ICH group: 102.00±24.56, non-ICH group: 117.02±37.60 mg/dL, p=0.063). However, after adjustment for the factors might affect the risk of post-tPA ICH, such as stroke severity, onset-to-treatment time interval, and atrial fibrillation (AF), LDL level was not associated with post-tPA ICH whereas AF was the only significant factor increased the risk of post-tPA ICH (adjusted OR: 1.177, 95% CI 1.080 to 1.283). In addition, patients with AF had significant lower LDL level and for patients without AF, LDL was not associated with the post-tPA ICH. In conclusion, LDL level is not associated with the risk of post-tPA ICH in Taiwanese patients with stroke.

  • stroke
  • lipoproteins
  • LDL

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  • Contributors CTH and LC: study design, data collection, data analysis, manuscript writing, manuscript revising. WTC: data collection, data analysis, manuscript writing. NFC, CJH and HHH: study design, manuscript revising. LYL: data collection.

  • Funding The study was funded by Academia Sinica Taiwan Biobank, Stroke Biosignature Project (BM10601010036).

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Joint Institutional Review Board of Taipei Medical University (TMU-JIRB; approval number N201705044).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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