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
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DOI：
10.1016/j.atherosclerosis.2017.12.008
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发表时间：
2018-02-01
期刊：
影响因子：
5.3
通讯作者：
Tsivgoulis, Georgios
中科院分区：
文献类型：
--
作者：
Chang, Jason J.;Katsanos, Aristeidis H.;Tsivgoulis, Georgios
背景和目标：脑出血后脂蛋白水平、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）与临床预后的关系仍存在争议。我们试图评估相关的脂蛋白胆固醇水平和他汀类药物剂量与临床和神经影像学结果的患者ICH.Methods：自发性急性脑出血连续住院患者的数据前瞻性收集超过5年的时间，并进行回顾性分析。记录人口统计学特征、通过NIHSS评分和ICH评分记录的临床严重程度、神经影像学参数、院前他汀类药物使用和剂量以及LDL-C和HDL-C水平。结果事件的特点是血肿体积，血肿扩大，在医院功能的结果，并在医院mortals.Results：共672例急性ICH [（平均年龄61.6 +/- 14.0岁，43.6%的女性，中位ICH评分1（IQR：0-2）]进行了评价。他汀类药物预处理与神经影像学或临床结局无关。较高的LDL-C水平与临床预后不良和住院死亡率的几个标志物相关。在多元线性回归模型中，LDL-C水平与血肿体积的立方根呈独立负相关（线性回归系数-0.021，95% CI：-0.042 - -0.001; p = 0.049）。入院时LDL-C较高（OR 0.88，95% CI 0.77-0.99; p = 0.048）也是血肿扩张减少的独立预测因素。入院时高LDL-C水平独立于（p < 0.001）与较低的住院死亡率相关（OR每10 mg/dL增加0.68，95%CI：0.57-0.80）。结论：入院时LDL-C水平较高是血肿扩大可能性较低的独立预测因素，急性自发性脑出血患者的住院死亡率这种关联需要独立确认。(c)2017 Elsevier B. V.版权所有。
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.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.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. (c) 2017 Elsevier B.V. All rights reserved.