Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
China National Clinical Research Center for Neurological Diseases, Beijing, China.
Oxid Med Cell Longev. 2022 Jun 18;2022:6206315. doi: 10.1155/2022/6206315. eCollection 2022.
Limited data were available about the combined impact of systolic blood pressure (SBP) and low-density lipoprotein cholesterol (LDL-C) levels on intracerebral hemorrhage (ICH) prognosis. The objective of this study is to explore whether the relationship between LDL-C and ICH outcomes was modified by SBP levels in a Chinese population. From August 1, 2015, to July 31, 2019, 75,443 ICH patients enrolled from the Chinese Stroke Center Alliance program were included in our study. Patients were divided into LDL-C levels of <70 mg/dL, 70-100 mg/dL, and ≥100 mmol/L. SBP was stratified as <140 mmHg, 140-180 mmHg, and ≥180 mmHg. The primary outcome was the occurrence of hematoma expansion (HE), and the second outcome was in-hospital mortality. Correlation between LDL-C levels and SBP on ICH outcomes were assessed by logistic regression. 6,116 (8.1%) and 1,576 (2.1%) patients suffered HE and in-hospital mortality. Compared with the ≥100 mg/dL group, patients with LDL-C concentrations under 70 mg/dL had a 19% and 24% increase in the relative risk of HE (crude OR 1.19, 95% CI 1.11-1.28) and in-hospital mortality (crude OR 1.24, 95% CI 1.08-1.42). When SBP was added as a stratification variable, the above-mentioned association was attenuated in patients under a threshold SBP of 140 mmHg ( > 0.05). However, no statistical interaction was detected between SBP and LDL-C levels. Lower LDL-C levels (<70 mg/dL) are related to a higher risk of HE and in-hospital mortality confined to ICH patients with elevated SBP (≥140 mmHg).
关于收缩压（SBP）和低密度脂蛋白胆固醇（LDL-C）水平对脑出血（ICH）预后的综合影响，相关数据有限。本研究旨在探讨在中国人群中，LDL-C 与 ICH 结局的关系是否受 SBP 水平的影响。
本研究纳入了 2015 年 8 月 1 日至 2019 年 7 月 31 日期间中国卒中中心联盟计划中的 75443 例 ICH 患者。将患者分为 LDL-C 水平<70mg/dL、70-100mg/dL 和≥100mmol/L 三组。SBP 分层为<140mmHg、140-180mmHg 和≥180mmHg。主要结局为血肿扩大（HE），次要结局为住院死亡率。采用逻辑回归评估 LDL-C 水平和 SBP 与 ICH 结局的相关性。6116（8.1%）和 1576（2.1%）例患者发生 HE 和住院死亡率。与 LDL-C 浓度≥100mg/dL 组相比，LDL-C 浓度<70mg/dL 的患者 HE（校正 OR 1.19，95%CI 1.11-1.28）和住院死亡率（校正 OR 1.24，95%CI 1.08-1.42）的相对风险增加了 19%和 24%。当 SBP 作为分层变量添加时，在 SBP 阈值为 140mmHg 以下的患者中，上述关联减弱（>0.05）。然而，未检测到 SBP 和 LDL-C 水平之间存在统计学交互作用。较低的 LDL-C 水平（<70mg/dL）与 SBP 升高（≥140mmHg）的 ICH 患者发生 HE 和住院死亡率的风险增加相关。
