Higher low-density lipoprotein cholesterol levels are associated with decreased mortality in patients with intracerebral hemorrhage.
Higher low-density lipoprotein cholesterol levels are associated with decreased mortality in patients with intracerebral hemorrhage.
- 2018
BACKGROUND AND AIMS: The relationship between lipoprotein levels, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and clinical outcome after intracerebral hemorrhage (ICH) remains controversial. We sought to evaluate the association of lipoprotein cholesterol levels and statin dosage with clinical and neuroimaging outcomes in patients with ICH. CONCLUSIONS: Higher LDL-C levels at hospital admission were an independent predictor for lower likelihood of hematoma expansion and decreased in-hospital mortality in patients with acute spontaneous ICH. This association requires independent confirmation. Copyright (c) 2017 Elsevier B.V. All rights reserved. METHODS: Data on consecutive patients hospitalized with spontaneous acute ICH was prospectively collected over a 5-year period and retrospectively analyzed. Demographic characteristics, clinical severity documented by NIHSS-score and ICH-score, neuroimaging parameters, pre-hospital statin use and doses, and LDL-C and HDL-C levels were recorded. Outcome events characterized were hematoma volume, hematoma expansion, in-hospital functional outcome, and in-hospital mortality. RESULTS: A total of 672 patients with acute ICH [(mean age 61.6 +/- 14.0 years, 43.6% women, median ICH score 1 (IQR: 0-2)] were evaluated. Statin pretreatment was not associated with neuroimaging or clinical outcomes. Higher LDL-C levels were associated with several markers of poor clinical outcome and in-hospital mortality. LDL-C levels were independently and negatively associated with the cubed root of hematoma volume (linear regression coefficient -0.021, 95% CI: -0.042--0.001; p = 0.049) on multiple linear regression models. Higher admission LDL-C (OR 0.88, 95% CI 0.77-0.99; p = 0.048) was also an independent predictor for decreased hematoma expansion. Higher admission LDL-C levels were independently (p < 0.001) associated with lower likelihood of in-hospital mortality (OR per 10 mg/dL increase 0.68, 95% CI: 0.57-0.80) in multivariable logistic regression models.
English
0021-9150
10.1016/j.atherosclerosis.2017.12.008 [doi] S0021-9150(17)31427-2 [pii]
*Cerebral Hemorrhage/bl [Blood]
*Cholesterol, LDL/bl [Blood]
*Dyslipidemias/bl [Blood]
*Hematoma/bl [Blood]
Aged
Biomarkers/bl [Blood]
Cerebral Hemorrhage/dg [Diagnostic Imaging]
Cerebral Hemorrhage/mo [Mortality]
Cholesterol, HDL/bl [Blood]
Dyslipidemias/di [Diagnosis]
Dyslipidemias/dt [Drug Therapy]
Dyslipidemias/mo [Mortality]
Female
Hematoma/dg [Diagnostic Imaging]
Hematoma/mo [Mortality]
Hospital Mortality
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors/ad [Administration & Dosage]
Male
Middle Aged
Neuroimaging/mt [Methods]
Patient Admission
Prognosis
Protective Factors
Retrospective Studies
Risk Factors
Time Factors
Tomography, X-Ray Computed
MedStar Washington Hospital Center
Medicine/Critical Care Medicine
Journal Article
BACKGROUND AND AIMS: The relationship between lipoprotein levels, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and clinical outcome after intracerebral hemorrhage (ICH) remains controversial. We sought to evaluate the association of lipoprotein cholesterol levels and statin dosage with clinical and neuroimaging outcomes in patients with ICH. CONCLUSIONS: Higher LDL-C levels at hospital admission were an independent predictor for lower likelihood of hematoma expansion and decreased in-hospital mortality in patients with acute spontaneous ICH. This association requires independent confirmation. Copyright (c) 2017 Elsevier B.V. All rights reserved. METHODS: Data on consecutive patients hospitalized with spontaneous acute ICH was prospectively collected over a 5-year period and retrospectively analyzed. Demographic characteristics, clinical severity documented by NIHSS-score and ICH-score, neuroimaging parameters, pre-hospital statin use and doses, and LDL-C and HDL-C levels were recorded. Outcome events characterized were hematoma volume, hematoma expansion, in-hospital functional outcome, and in-hospital mortality. RESULTS: A total of 672 patients with acute ICH [(mean age 61.6 +/- 14.0 years, 43.6% women, median ICH score 1 (IQR: 0-2)] were evaluated. Statin pretreatment was not associated with neuroimaging or clinical outcomes. Higher LDL-C levels were associated with several markers of poor clinical outcome and in-hospital mortality. LDL-C levels were independently and negatively associated with the cubed root of hematoma volume (linear regression coefficient -0.021, 95% CI: -0.042--0.001; p = 0.049) on multiple linear regression models. Higher admission LDL-C (OR 0.88, 95% CI 0.77-0.99; p = 0.048) was also an independent predictor for decreased hematoma expansion. Higher admission LDL-C levels were independently (p < 0.001) associated with lower likelihood of in-hospital mortality (OR per 10 mg/dL increase 0.68, 95% CI: 0.57-0.80) in multivariable logistic regression models.
English
0021-9150
10.1016/j.atherosclerosis.2017.12.008 [doi] S0021-9150(17)31427-2 [pii]
*Cerebral Hemorrhage/bl [Blood]
*Cholesterol, LDL/bl [Blood]
*Dyslipidemias/bl [Blood]
*Hematoma/bl [Blood]
Aged
Biomarkers/bl [Blood]
Cerebral Hemorrhage/dg [Diagnostic Imaging]
Cerebral Hemorrhage/mo [Mortality]
Cholesterol, HDL/bl [Blood]
Dyslipidemias/di [Diagnosis]
Dyslipidemias/dt [Drug Therapy]
Dyslipidemias/mo [Mortality]
Female
Hematoma/dg [Diagnostic Imaging]
Hematoma/mo [Mortality]
Hospital Mortality
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors/ad [Administration & Dosage]
Male
Middle Aged
Neuroimaging/mt [Methods]
Patient Admission
Prognosis
Protective Factors
Retrospective Studies
Risk Factors
Time Factors
Tomography, X-Ray Computed
MedStar Washington Hospital Center
Medicine/Critical Care Medicine
Journal Article