Deans' stroke musings: Cholesterol ‘paradox’ in survival after stroke thrombolysis

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, December 12, 2011

Cholesterol ‘paradox’ in survival after stroke thrombolysis

More stuff to show that they really have no clue on how much cholesterol we really need.
http://www.medwire-news.md/39/96251/Stroke/Cholesterol_%E2%80%98paradox%E2%80%99_in_survival_after_stroke_thrombolysis.htm l
Cholesterol levels in patients with ischemic stroke are inversely related to survival after intravenous thrombolysis, report Spanish researchers.

"The mechanism of this apparent paradox, common to both ischaemic and hemorrhagic strokes, remains unexplained, and merits further research," say Jaume Roquer (Hospital del Mar, Barcelona) and colleagues.

The team measured cholesterol levels in 220 patients with ischemic stroke who underwent intravenous thrombolysis within 4.5 hours of symptom onset. In all, 15% of patients died within 3 months of treatment.

As expected, stroke severity, as measured on the National Institutes of Health Stroke Scale (NIHSS), was the most significant determinant of patient survival at 3 months in all multivariate models. NIHSS score did not correlate with high-density lipoprotein cholesterol, but correlated inversely with patients' levels of total cholesterol, triglycerides, and low-density lipoprotein cholesterol.

Despite this, total cholesterol levels were significantly inversely associated with survival, and remained so after accounting for stroke severity.

Other lipid measures were not significantly associated with mortality, but for total cholesterol, 3-month mortality fell from 25.7% in the lowest cholesterol tertile (<155 mg/dL; 4.0 mmol/L) to 13.7% in the middle tertile (155-192 mg/dL; 4.0-4.9 mmol/L) and just 5.5% in the highest tertile (>192 mg/dL; 4.9 mmol/L).

"Our study does not allow us to identify the reason why low cholesterol is associated with increased mortality after [ischemic stroke], although we could hypothesize that this is an epiphenomenon or a surrogate marker of poor prognosis rather than an effect related to cholesterol levels," say Roquer et al in the European Journal of Neurology.

However, they note that cholesterol is essential for cell membrane function, and has many other important roles, making it "plausible" that high plasma cholesterol levels could be neuroprotective.