Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Lower low-density lipoprotein cholesterol levels are associated with an increased risk of hematoma expansion and ensuing mortality in acute ICH patients
First author：Yu Wang
Corresponding author：Xingquan Zhao,Yongjun Wang
essential_information
2021-11-22
Published articles
Journal：Neurological Sciences
Publication type: Article
IF(IF): 3.307
PMID: 34806117 Link To Pubmed Full text Download
Background And Purpose
The relationship between lipid levels and the prognosis of acute intracerebral hemorrhage (ICH) remains controversial. Thus, we aimed to investigate whether lower low-density lipoprotein cholesterol (LDL-C) levels increased the risk of adverse outcomes, as well as the current situation of statin treatment in acute ICH patients with premorbid lipid-lowering therapy.
Method
From August 1, 2015, to July 31, 2019, a total of 73,098 ICH patients were included in our study from the Chinese Stroke Center Alliance program. Patients were grouped by LDL-C levels of <1.4 mmol/L, 1.4-1.8 mmol/L, 1.8-2.6 mmol/L, and >2.6 mmol/L. Logistic regression was used to assess the association between LDL-C levels and the composite risk of hematoma expansion (HE) or in-hospital death. Moreover, statin treatment in ICH patients with cardio-cerebrovascular diseases was analyzed.
Conclusion
Lower LDL-C levels (<1.4mmol/L) are associated with an increased risk of HE and ensuing mortality in acute ICH patients. Maintaining an optimal LDL-C range may have therapeutic potential against HE which merits further investigation.
Main results
6,368 (8.7%) patients were identified as a composite of HE or in-hospital death with a mean LDL-C level of 2.9±1.7 mmol/L. In the univariate analysis, patients who achieved lower LDL-C concentrations under 1.4 mmol/L had a 36% higher risk of adverse outcomes compared with the ≥2.6 mmol/L group (OR 1.36, 95%CI 1.23-1.51). Similar results were obtained in multivariate analyses, especially for patients with GCS scores of 9-15. For acute ICH patients with concomitant atherosclerotic disease, statin treatment was discontinued in the majority of Chinese population.