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Publications

Journal Article Ahead of print

PubMed: 41795922 DOI: 10.5551/jat.65992

A Low LDL-C Level but not Statin Use is Associated with In-hospital Mortality in Spontaneous Intracerebral Hemorrhage; The J-ICH Registry.

J Atheroscler Thromb

Authors: Kazo Kanazawa, Nobukazu Miyamoto, Hideaki Ueno, Satoshi Tsutsumi, Rikizo Saito, Joji Tokugawa, Yuji Ueno, Kazuo Yamashiro, Munetaka Yamamoto, Yukimasa Yasumoto, Makoto Hishii, Takuji Yamamoto, Chikashi Maruki, Takao Urabe, Akihide Kondo, Hajime Arai, Nobutaka Hattori, Ryota Tanaka

Affiliations

  • Department of Neurology, Juntendo University School of Medicine.
  • Department of Neurosurgery, Juntendo University Urayasu Hospital.
  • Department of Neurosurgery, Koshigaya Municipal Hospital.
  • Department of Neurosurgery, Juntendo University Nerima Hospital.
  • Department of Neurology, University of Yamanashi.
  • Department of Neurology, Juntendo University Urayasu Hospital.
  • Department of Neurosurgery, Juntendo University School of Medicine.
  • Department of General Medicine, Juntendo University Urayasu Hospital.
  • Department of Neurosurgery, Juntendo University Shizuoka Hospital.
  • Stroke Center and Division of Neurology, Department of Medicine, Jichi Medical University.

Abstract

AIM

A reduction in low-density lipoprotein cholesterol (LDL-C) is beneficial for vascular diseases; however, lower LDL-C levels may be associated with an increased risk of spontaneous intracerebral hemorrhage (sICH). The present study investigated the relationship between the LDL-C levels and in-hospital mortality after sICH using data from the Juntendo Registry of Spontaneous Intra-Cerebral Hemorrhage (J-ICH registry).

METHODS

Patients aged ≥ 20 years with non-traumatic sICH admitted to five Juntendo-affiliated hospitals between September 2016 and December 2019 were enrolled in this study. The relationships between the LDL-C levels and in-hospital mortality, statin therapy, and antithrombotic therapy were analyzed.

RESULTS

Among the 1,017 patients with sICH, lower LDL-C levels were associated with older age, a lower BMI, a larger hematoma volume, more severe neurological deficits, and a higher in-hospital mortality. A logistic regression analysis confirmed that LDL-C ＜100 mg/dL independently increased the risk of in-hospital death, along with age, the NIHSS score, hematoma volume, and intraventricular hemorrhage. Subgroup analyses showed that the association between low LDL-C levels and mortality was particularly evident in patients with deep/infratentorial intracerebral hemorrhage, those managed without surgery, and those without prior statin use. Prior statin use was associated with a potential protective effect against in-hospital mortality and hematoma volume.

CONCLUSION

This study demonstrated that lower LDL-C levels were associated with a higher in-hospital mortality after sICH, whereas prior statin use was not associated with poorer outcomes and may instead offer a protective effect.

MeSH

Registries, Mortality, Cerebral Hemorrhage, Cholesterol, Ldl, Hemorrhage, Hematoma, Hospital Mortality, Aged, Arteriosclerosis, Therapeutics, Thrombosis, Hydroxymethylglutaryl-Coa Reductase Inhibitors