Low-density lipoprotein cholesterol, statin therapy, and cerebral microbleeds: The CIRCLE study

Area of Science:

• Neurology
• Cardiovascular Research
• Biochemistry

Background:

• Cerebral microbleeds (CMBs) are associated with cardiovascular risk factors.
• The relationship between low-density lipoprotein cholesterol (LDL-C) levels, statin use, and CMBs is not fully understood.
• This study investigates these associations in a stroke-free population.

Purpose of the Study:

• To prospectively examine the relationship between LDL-C levels and the incidence of new CMBs.
• To evaluate the impact of statin use on the development of new CMBs in a stroke-free cohort.

Main Methods:

• Prospective cohort study (CIRCLE study) of 209 stroke-free individuals with cerebral small vessel disease markers.
• Baseline LDL-C levels were stratified into quartiles.
• 1-year follow-up with susceptibility-weighted imaging (SWI) to detect new CMBs (lobar and deep).

Main Results:

• The incidence of new deep CMBs was highest in the lowest LDL-C quartile (Q1: ≤1.76 mmol/L) at 30.0%.
• Low LDL-C (Q1) was significantly associated with an increased incidence of new deep CMBs (OR=4.256, p=0.029).
• In participants without prior statin use, atorvastatin use was associated with reduced new deep CMBs (OR=0.181, p=0.040), while rosuvastatin showed no significant effect.

Conclusions:

• Lower LDL-C levels are associated with a higher incidence of new deep CMBs.
• Statin therapy, specifically atorvastatin, may have a protective effect against new CMB development.
• These findings suggest that statins do not increase CMB risk and may be beneficial in certain populations.