on March 19, 2009
Published online before print March 19, 2009, doi: 10.1161/STROKEAHA.108.536698
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Submitted on September 7, 2008
From the Section of Neurology (J.M.R.-M.), Infanta Cristina Universitary Hospital, Badajoz, Spain; and the Stroke Unit, Section of Neurology (I.C.-N., J.C.P., M.C., D.T., A.F., A.S.), San Pedro de Alcántara Hospital, Cáceres, Spain. * To whom correspondence should be addressed. E-mail: jramirezm{at}meditex.es.
Background and Purpose—Prognostic significance of low-density lipoprotein cholesterol (LDL-C) in intracranial hemorrhage (ICH) is unclear. The objective of this study was to determine the association between LDL-C and mortality in ICH. Methods—Consecutive patients (n=88) presenting with ICH were included in the study. Lipid profile was obtained during the first hours after admission. We analyzed the impact of LDL-C on 90-day mortality using the Hazard Rate (HR) crude, analysis crude for trend by Mantel–Haenszel Test, Multiple Cox Proportional Hazards model, and analysis of survival curves. Association between LDL-C and severity markers of ICH were explored using Spearman correlation coefficient. Results—Low LDL-C levels were independently associated with death after intracranial hemorrhage (HR=3.07 (95% CI:1.04 to 9.02; P=0.042) in multivariable analysis after controlling for confounding factors. Analysis for trend showed a significant association (Xt=-2.144; P=0.032) by Mantel-Haenszel Test. Spearman analysis showed no correlation between LDL-C and variables that are markers of ICH severity: NIH score (r=-0.091; P=0.400), GCS score (r=0.136; P=0.207), ICH volume (r=0.140; P=0.192), and length of stay (r=-0.111; P=0.308). Conclusions—Low levels of LDL-C are independently associated with an increased risk of death in patients with brain hemorrhage. We have not found evidences that the levels of LDL-C can act as a biological marker of severity.
Accepted on September 17, 2008
Serum Cholesterol LDL and 90-Day Mortality in Patients With Intracerebral Hemorrhage
José María Ramírez-Moreno MD*;
Key words: cardiovascular disease • intracerebral haemorrhage • prognosis • cholesterol • low-density lipoprotein cholesterol