OBJECTIVE: We aimed to evaluate whether serum lipid levels can influence the clinicoradiological recovery of intracerebral hemorrhage (ICH) in prior statin users. PATIENTS AND METHODS: Medical records were reviewed retrospectively in 381 ICH patients (253 men and 128 women). Cardiovascular disease (CVD) risk factors, blood pressure at admission and the first in-hospital day, admission and 30-day scores of National Institute Health Stroke Scale (NIHSS) and modified Rankin scale (mRS), hematoma volume (HV), serum lipid levels were compared between prior statin users and non-users. RESULTS: Statins were pretreated in 56 patients (31 men and 25 women). Statin users were older age, and had higher frequencies of dyslipidemia, diabetes mellitus, atrial fibrillation, prior stroke history and large HV compared to non-users. Serum levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) were significantly decreased in the statin group compared to the non-statin group. There were no statistical differences in the other CVD risk factors, functional scores and other serum lipid levels between the two groups. HV was correlated inversely with serum levels of TC and LDL-C in both groups. Multiple logistic regression analysis showed that serum TC levels ≤150 mg/dL were associated with statin use [Odds ratio (OR)=5.5, 95% confidence interval (CI)=1.55-19.58], worsening of NIHSS score (OR=1.4, 95% CI=1.21-1.63) and HV (OR=1.1, 95% CI=1.07-1.13) in ICH patients. A significant association was found between worsening of NIHSS score (OR=2.0, 95% CI=1.32-3.12) and worsening of mRS score (OR=3.3, 95% CI=1.33-8.00), HV (OR=1.3, 95% CI=1.01-1.76), and serum TC levels ≤150 mg/dL in statin users. CONCLUSION: Prior statin users with serum TC levels ≤150 mg/dL had worsening of outcome and HV. Excessive lowering of serum TC levels due to statin pretreatment may cause unfavorable clinicoradiological recovery of ICH. Physicians should monitor serum lipid levels carefully in statin users.
OBJECTIVE: We aimed to evaluate whether serum lipid levels can influence the clinicoradiological recovery of intracerebral hemorrhage (ICH) in prior statin users. PATIENTS AND METHODS: Medical records were reviewed retrospectively in 381 ICHpatients (253 men and 128 women). Cardiovascular disease (CVD) risk factors, blood pressure at admission and the first in-hospital day, admission and 30-day scores of National Institute Health Stroke Scale (NIHSS) and modified Rankin scale (mRS), hematoma volume (HV), serum lipid levels were compared between prior statin users and non-users. RESULTS: Statins were pretreated in 56 patients (31 men and 25 women). Statin users were older age, and had higher frequencies of dyslipidemia, diabetes mellitus, atrial fibrillation, prior stroke history and large HV compared to non-users. Serum levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) were significantly decreased in the statin group compared to the non-statin group. There were no statistical differences in the other CVD risk factors, functional scores and other serum lipid levels between the two groups. HV was correlated inversely with serum levels of TC and LDL-C in both groups. Multiple logistic regression analysis showed that serum TC levels ≤150 mg/dL were associated with statin use [Odds ratio (OR)=5.5, 95% confidence interval (CI)=1.55-19.58], worsening of NIHSS score (OR=1.4, 95% CI=1.21-1.63) and HV (OR=1.1, 95% CI=1.07-1.13) in ICHpatients. A significant association was found between worsening of NIHSS score (OR=2.0, 95% CI=1.32-3.12) and worsening of mRS score (OR=3.3, 95% CI=1.33-8.00), HV (OR=1.3, 95% CI=1.01-1.76), and serum TC levels ≤150 mg/dL in statin users. CONCLUSION: Prior statin users with serum TC levels ≤150 mg/dL had worsening of outcome and HV. Excessive lowering of serum TC levels due to statin pretreatment may cause unfavorable clinicoradiological recovery of ICH. Physicians should monitor serum lipid levels carefully in statin users.
Authors: Gayle R Pletsch; Amelia K Boehme; Karen C Albright; Christopher Burns; T Mark Beasley; Sheryl Martin-Schild Journal: Cerebrovasc Dis Extra Date: 2014-01-22