Associations between low-density lipoprotein cholesterol and haemorrhagic stroke

Area of Science:

• Neurology
• Cardiovascular Medicine
• Clinical Research

Background:

• Haemorrhagic stroke is a significant cause of mortality and morbidity.
• Low-density lipoprotein cholesterol (LDL-C) is a known risk factor for ischemic stroke, but its role in haemorrhagic stroke is less understood.
• Understanding the relationship between LDL-C and haemorrhagic stroke outcomes is crucial for patient management.

Purpose of the Study:

• To investigate the association between blood LDL-C concentrations and clinical features of haemorrhagic stroke.
• To determine if LDL-C levels correlate with the severity of neurological deficits and patient outcomes.
• To identify potential prognostic value of LDL-C in haemorrhagic stroke patients.

Main Methods:

• Retrospective analysis of 606 patients with acute haemorrhagic stroke admitted between 2013 and 2018.
• Patients were categorized into three baseline LDL-C groups: < 70 mg/dL, 70 to < 100 mg/dL, and ≥ 100 mg/dL.
• Multivariate logistic regression models were used to assess the association between LDL-C levels and severe neurological deficits (NIHSS ≥ 15) and unfavourable outcomes (mRS > 2).

Main Results:

• Patients with higher LDL-C levels (≥ 70 mg/dL) were less likely to experience severe neurological deficits compared to those with LDL-C < 70 mg/dL (adjusted ORs ranging from 0.27 to 0.29).
• Higher LDL-C levels were also associated with a reduced risk of unfavourable outcomes at discharge (adjusted ORs ranging from 0.46 to 0.50).
• A significant proportion of patients (56%) had LDL-C levels ≥ 100 mg/dL.

Conclusions:

• Low LDL-C levels (< 70 mg/dL) were independently associated with severe neurological deficits in patients with haemorrhagic stroke.
• Lower LDL-C concentrations may increase the risk of unfavourable outcomes following haemorrhagic stroke.
• These findings highlight a potential paradox where lower LDL-C might be detrimental in the context of haemorrhagic stroke.