We evaluated the relationship between LDL levels and risk of hemorrhagic transformation in patients who underwent mechanical thrombectomy.

Ischemic Stroke is one of the leading causes of mortality and morbidity in the US. Hemorrhagic Transformation (HT) is one the most feared complications of ischemic stroke increasing its mortality and disability, especially in the setting of use of TPA and/or intervention with mechanical thrombectomy.  Factors such as uncontrolled blood pressures, higher baseline glucose levels have been found to increase the risk of hemorrhagic transformation in such patients. LDL levels have been linked to hemorrhagic transformation although with limited evidence. 

This is a retrospective study in patients who underwent thrombectomy from 2016 to 2017 at a tertiary referral center. Primary outcome were LDL levels and HT at 24 hours in patients who underwent mechanical thrombectomy. Subject stratification was done based on patient’s age, sex, stroke side and location, blood pressure, anti-hypertensive medications (AHMs), admission type (direct emergency room admission versus outside hospital transfer), and lab values on admission. 

Logistic regression model including only age, gender, and LDL levels as predicting variables was performed. Data analysis was performed using SAS software, Version 9.1 of the SAS System for Windows (SAS Institute, Cary, NC).

There were total of 46 patients that underwent thrombectomy, 25 of them had hemorrhagic transformation. LDL levels were drawn on admission. Higher LDL levels were statistically significant in predicting the odds of HT. Among patients who underwent successful thrombectomy, higher LDL levels were found to be significantly associated with higher odds of HT (OR=1.023, 95% C.I. 1.001-1.046; P=0.0375) while adjusting for age and gender.

Higher baseline LDL levels are associated with increased risk of hemorrhagic transformation in patients undergoing mechanical thrombectomy.