Cui Chaohua, Guan Haoye, Long Tonghua, Liang Yuru
Life Science and Clinical Medicine Research Center, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi, China.
Front Neurol. 2025 Jun 24;16:1573036. doi: 10.3389/fneur.2025.1573036. eCollection 2025.
Statins were effective in preventing ischemic stroke in patients with intracerebral hemorrhage (ICH). Statins administered at normal doses may contribute to hematoma expansion. We employed unsupervised machine learning methods and found that low-dose statins improve the prognosis of ICH.
We employed unsupervised machine learning techniques to analyze unidentified factors within a retrospective cohort related to the prognosis of ICH. In our prospective cohort study, data were gathered from ICH patients over a three-year period. Outcomes included mortality, cerebrovascular events within 3 years, unfavorable functional outcomes at 3 months, and hematoma expansion during hospitalization.
The heatmap illustrated distinct statin effect trajectories, emphasizing the substantial impact of low-dose statins on prognosis. The low-dose statin group exhibited reduced mortality ( = 0.001), a decreased rate of unfavorable functional outcomes ( < 0.001), and fewer cerebrovascular events ( < 0.001). Both groups demonstrated a comparable rate of hematoma expansion ( = 0.735). In multivariable Cox regression analyses, low-dose statins were associated with reduced mortality (RR = 0.505, = 0.022) and decreased ischemic stroke occurrence (RR = 0.354, < 0.001). Additionally, low-dose statins were linked to better functional outcomes (OR = 0.594, < 0.001) but showed no significant association with hematoma expansion (OR = 1.056, = 0.735).
Unsupervised machine learning revealed a correlation between low-dose statins and patient prognosis. Subsequent analyses and validation indicated that for patients with intracerebral hemorrhage (ICH) in the cerebral hemisphere, early administration of low-dose hydrophilic statins is associated with reduced mortality, and statins are associated with a reduced rate of ischemic stroke occurrence. For all ICH patients, low-dose statins are associated with a lower rate of unfavorable functional outcomes but show no significant association with hematoma expansion.
他汀类药物在预防脑出血（ICH）患者发生缺血性卒中方面有效。正常剂量使用他汀类药物可能会导致血肿扩大。我们采用无监督机器学习方法，发现低剂量他汀类药物可改善脑出血的预后。
我们采用无监督机器学习技术分析回顾性队列中与脑出血预后相关的未知因素。在我们的前瞻性队列研究中，在三年期间收集了脑出血患者的数据。结局包括死亡率、3年内的脑血管事件、3个月时不良功能结局以及住院期间的血肿扩大情况。
热图显示了他汀类药物不同的效应轨迹，强调了低剂量他汀类药物对预后的重大影响。低剂量他汀类药物组的死亡率降低（P = 0.001），不良功能结局发生率降低（P < 0.001），脑血管事件减少（P < 0.001）。两组的血肿扩大率相当（P = 0.735）。在多变量Cox回归分析中，低剂量他汀类药物与死亡率降低相关（风险比[RR] = 0.505，P = 0.022）以及缺血性卒中发生率降低相关（RR = 0.354，P < 0.001）。此外，低剂量他汀类药物与更好的功能结局相关（比值比[OR] = 0.594，P < 0.001），但与血肿扩大无显著关联（OR = 1.056，P = 0.735）。
无监督机器学习揭示了低剂量他汀类药物与患者预后之间的相关性。后续分析和验证表明，对于大脑半球脑出血（ICH）患者，早期给予低剂量亲水性他汀类药物与死亡率降低相关，且他汀类药物与缺血性卒中发生率降低相关。对于所有脑出血患者，低剂量他汀类药物与不良功能结局发生率较低相关，但与血肿扩大无显著关联。
