Low LDL-C level and intracranial haemorrhage risk after ischaemic stroke:a prospective cohort study

作     者：Jie Xu Zimo Chen Meng Wang Jinglin Mo Jing Jing Gulbahram Yalkun Liye Dai Xia Meng Hao Li Zixiao Li Yongjun Wang 

作者机构：Department of NeurologyBeijing Tiantan HospitalCapital Medical UniversityBeijingFengtaiChina China National Clinical Research Center for Neurological DiseasesBeijingChina 

出 版 物：《Stroke & Vascular Neurology》 (卒中与血管神经病学（英文）)

年 卷 期：2023年第8卷第2期

页      面：127-133页

核心收录：

学科分类：1002[医学-临床医学] 100204[医学-神经病学] 10[医学] 

基　　金：supported by grants from the Ministry of Science and Technology of the People’s Republic of China(2016YFC0901002,2016YFC0901001,2017YFC1310901,2017YFC1307905,2018YFC1312903) grants from Beijing Municipal Administration of Hospitals’Mission Plan(SML20150502) grants from Beijing Municipal Science&Technology Commission(D171100003017002,D151100002015003) grants from National Science and Technology Major Project(2017ZX09304018) 

主　　题：intracranial prospective cholesterol 

摘      要：Background and purpose The Treat Stroke to Target trial has confirmed the benefit of targeting low-density lipoprotein cholesterol(LDL-C)of1.8 mmol/L in patients who had an ischaemic stroke(IS).However,haemorrhagic risk brought by this target level(1.8 mmol/L)or even lower level(1.4 mmol/L)of LDL-C should also be *** this study,we aimed to demonstrate whether low LDL-C could increase the intracranial haemorrhage risk following *** Patients who had an IS from China Stroke Center Alliance programme with complete baseline information were prospectively enrolled.793572 patients who had an IS were categorised into 6 groups according to LDL-C level(1.40 mmol/L,1.40-1.79 mmol/L,1.80-2.59 mmol/L,2.60-2.99 mmol/L,3.00-4.89 mmol/L,≥4.90 mmol/L).The study outcome was defined as intracranial haemorrhage identified during *** regression model was used to examine the association between different LDL-C levels and risk of intracranial *** Compared with patients of LDL-C=1.80-2.59 mmol/L,both subgroups of LDL-C1.40 mmol/L and LDL-C=1.40-1.79 mmol/L showed significantly higher risk of intracranial haemorrhage(OR=1.26,95%CI=1.18 to 1.35;OR=1.22,95%CI=1.14 to 1.30,respectively).Interaction effect was found to exist between the subgroups of intravenous thrombolytic therapy(p=0.04),rather than the subgroups of age,sex and body mass ***,the sensitivity analyses indicated that even patients who had an IS with minor stroke still suffered from the increased intracranial haemorrhage risk related to low LDL-C *** Among patients who had an IS,the low LDL-C level(1.4 mmol/L or1.8 mmol/L)at baseline is associated with increased risk of intracranial haemorrhage during acute *** actively lowering LDL-C level for patients who had an IS,clinicians should also concern about the haemorrhagic risk associated with low LDL-C level.