Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland.
Stroke. 2013 Aug;44(8):2330-2. doi: 10.1161/STROKEAHA.113.001829. Epub 2013 Jun 11.
It is unclear whether blood lipid profiles and statin use before intracerebral hemorrhage (ICH) are associated with its outcome.
The Helsinki ICH Study, a single-center observational registry of consecutive ICH patients, was used to study the associations between premorbid statin use, baseline lipid levels, and clinical outcome.
The registry includes 964 ICH patients. Statin users (n=187; 19%) were significantly older, had more frequent comorbidities and medication, lower lipid levels, and higher admission Glasgow Coma Scale compared with nonusers. Modified Rankin Scale at discharge or mortality did not differ between statin users and nonusers. Compared with survivors, significantly lower total cholesterol and low-density lipoprotein cholesterol levels were observed in patients who died in hospital (median, 4.1 mmol/L [interquartile range, 3.6-4.4] versus 4.5 [3.8-5.1]; P<0.01; 1.9 mmol/L [1.4-2.5] versus 2.4 [1.8-3.0]; P<0.001, respectively), at 3 or 12 months. After adjusting for known ICH prognostic factors based on univariate analysis that is, age, National Institutes of Health Stroke Scale, Glasgow Coma Scale, ICH volume, and intraventricular location, lower low-density lipoprotein levels were independently associated with in-hospital mortality (odds ratio, 0.54 [95% confidence interval, 0.31-0.93]; P=0.028).
Premorbid statin use did not affect the outcome of ICH, but lower low-density lipoprotein levels were associated with higher in-hospital mortality.
目前尚不清楚颅内出血（ICH）发病前的血脂水平和他汀类药物的使用情况与ICH 结局之间是否存在关联。
采用赫尔辛基 ICH 研究（一项针对连续ICH 患者的单中心观察性登记研究），研究发病前他汀类药物使用、基线血脂水平与临床结局之间的关系。
该登记研究纳入了 964 例 ICH 患者。与非使用者相比，他汀类药物使用者（187 例，19%）年龄更大，合并症和用药更为频繁，血脂水平更低，入院时格拉斯哥昏迷量表评分更高。他汀类药物使用者和非使用者出院时或随访 12 个月时的改良 Rankin 量表评分无差异。与存活者相比，住院死亡者的总胆固醇和低密度脂蛋白胆固醇水平显著更低（中位数分别为 4.1mmol/L [四分位距 3.6-4.4] 与 4.5mmol/L [3.8-5.1]；P<0.01；1.9mmol/L [1.4-2.5] 与 2.4mmol/L [1.8-3.0]；P<0.001），且在发病后 3 个月和 12 个月也是如此。在校正单因素分析中基于已知 ICH 预后因素（年龄、美国国立卫生研究院卒中量表评分、格拉斯哥昏迷量表评分、ICH 体积和脑室内位置）后，低密度脂蛋白水平较低与住院期间死亡率独立相关（比值比 0.54 [95%置信区间 0.31-0.93]；P=0.028）。
发病前他汀类药物的使用并未影响 ICH 的结局，但较低的低密度脂蛋白水平与较高的住院期间死亡率相关。
