Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

Journal：Stroke and Vascular Neurology

Publication type: Original Contributions

IF(IF): 9.893

PMID: 36162902 Link To Pubmed Full text Download

Currently, the “post-statin” era has came and the emerge of combined therapy of “statin+ezetimibe”, “statin+PCSK-9” and “statin+ezetimibe+PCSK-9” have called on the need of aggressive lipid-lowering therapy. However, concerns still exist about the hemorrhagic risk brought by reduction of LDL-c. Moreover, according to the 2017 announced AACE and ACE guideline and the updated ESC/EAS guidelines for lipid management stated, there is no lower limit for LDL-c reduction above 1.0 mmol/L (40 mg/dL), which begun a new era for lipid-lowering therapy and supported the mantra of “lower is better” for LDL-c reduction. For patients with ischemic stroke, one of the major population for lipid-lowering therapy, evidence still remains limited on the correlation between low level of LDL-c and hemorrhagic risk, especially for the data of real world with large sample size. In this study, we aimed to investigate whether the low level of LDL-c may increase the risk of hemorrhagic events including hemorrhagic transformation and hemorrhagic stroke, among ischemic stroke patients during hospitalization.

Patients who had an IS from China Stroke Center Alliance programme with complete baseline information were prospectively enrolled. 793 572 patients who had an IS were categorised into 6 groups according to LDL-C level (<1.40mmol/L, 1.40–1.79mmol/L, 1.80–2.59mmol/L, 2.60–2.99mmol/L, 3.00–4.89mmol/L, ≥4.90mmol/L). The study outcome was defined as intracranial haemorrhage identified during hospitalisation. Logistic regression model was used to examine the association between different LDL-C levels and risk of intracranial haemorrhage.