Progress of the correlation between high-density lipoprotein cholesterol and hemorrhagic transformation after intravenous thrombolysis in acute ischemic stroke
Ischemic stroke is the most common type of cerebrovascular disease,serving as a primary cause of global mortality and disability,and accounting for over 80%of all strokes in China.Over the past two decades,the age-standardized incidence and prevalence of ischemic stroke have increased by 34.7%and 33.5%,respectively.The standard treatment for acute ischemic stroke(AIS)patients within the onset time window is the use of recombinant tissue-type plasminogen activator(rt-PA)for intravenous thrombolysis,but it comes with the risk of hemorrhagic transformation.Hemorrhagic transformation,as a severe complication of AIS reperfusion therapy,has impeded the widespread clinical application of intravenous thrombolysis to some extent,particularly in moderate to severe AIS cases where the risk of hemorrhagic transformation is elevated.Exploring the risk factors and constructing risk models for the early identification of high-risk stroke patients for hemorrhagic transformation has been a recent research focus.In recent years,studies have found a close association between elevated levels of high-density lipoprotein cholesterol(HDL-C)and increased risk of hemorrhagic transformation following AIS intravenous thrombolysis.This paper provides a review of the research progress on the correlation between HDL-C levels and hemorrhagic transformation after intravenous thrombolysis in AIS patients,and initiates a preliminary discussion on possible mechanisms,aiming to provide a theoretical basis for further research in the related field.