High-Density Lipoprotein Is Associated with Progression of Intracranial Aneurysms

Area of Science:

• Neurology
• Cardiovascular Medicine
• Lipid Metabolism

Background:

• Intracranial aneurysms pose significant health risks, with their growth and rupture influenced by various physiological factors.
• The role of high-density lipoprotein (HDL) in the development and progression of intracranial aneurysms remains an area of active investigation.

Purpose of the Study:

• To investigate the association between high-density lipoprotein (HDL) levels and the growth and rupture of intracranial aneurysms.
• To identify predictive factors for aneurysm size and rupture, with a focus on HDL levels and other clinical parameters.

Main Methods:

• An observational cohort study was conducted involving 581 patients with intracranial aneurysms.
• Data collected included patient demographics, comorbidities (hypertension, diabetes, coronary artery disease), blood pressure, lipid profiles (HDL, APO-A1, APO-B, LDL, triglycerides, cholesterol), and aneurysm characteristics (location, size).
• Aneurysms smaller than 8 mm were classified as small.

Main Results:

• Higher HDL levels were associated with smaller aneurysm size (OR, 0.327; P=0.0002) and were a predictor of aneurysmal rupture (OR, 3.716; P=0.002).
• In male patients, lower HDL was linked to larger aneurysm size (P=0.015).
• Predictors of aneurysmal rupture included small size, higher HDL, absence of coronary artery disease, lower APO-A1, and higher systolic blood pressure. An HDL/aneurysm size ratio >0.31 significantly increased rupture likelihood (OR, 46.214; P=0.002).

Conclusions:

• HDL levels show an inverse relationship with intracranial aneurysm growth, notably in men.
• Elevated HDL levels, coupled with small aneurysm size, are associated with an increased risk of aneurysmal rupture.
• The HDL/aneurysm size ratio serves as a valuable predictive marker for intracranial aneurysm rupture.