Low-density lipoprotein cholesterol and risk of intracerebral hemorrhage: A prospective study

Chaoran Ma, M. Edip Gurol, Zhe Huang, Alice H. Lichtenstein, Xiuyan Wang, Yuzhen Wang, Samantha Neumann, Shouling Wu, Xiang Gao

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Abstract

OBJECTIVE: To prospectively examine the association between low-density lipoprotein (LDL) cholesterol (LDL-C) concentrations and intracerebral hemorrhage (ICH) risk. METHODS: The current cohort study included 96,043 participants (mean age 51.3 years) who were free of stroke, myocardial infarction, and cancer at baseline (2006). Serum LDL-C concentrations were assessed in 2006, 2008, 2010, and 2012. Cumulative average LDL-C concentrations were calculated from all available LDL-C data during that period. Incident ICH was confirmed by review of medical records. RESULTS: We identified 753 incident ICH cases during 9 years of follow-up. The ICH risk was similar among participants with LDL concentrations of 70 to 99 mg/dL and those with LDL-C concentrations ≥100 mg/dL. In contrast, participants with LDL-C concentrations <70 mg/dL had a significantly higher risk of developing ICH than those with LDL-C concentrations of 70 to 99 mg/dL; adjusted hazard ratios were 1.65 (95% confidence interval [CI] 1.32-2.05) for LDL-C concentrations of 50 to 69 mg/dL and 2.69 (95% CI 2.03-3.57) for LDL-C concentrations <50 mg/dL. CONCLUSIONS: We observed a significant association between lower LDL-C and higher risk of ICH when LDL-C was <70 mg/dL, and the association became nonsignificant when LDL-C ≥70 mg/dL. These data can help determination of the ideal LDL range in patients who are at increased risk of both atherosclerotic disease and hemorrhagic stroke and guide planning of future lipid-lowering studies.

Original languageEnglish (US)
Pages (from-to)e445-e457
JournalNeurology
Volume93
Issue number5
DOIs
StatePublished - Jul 30 2019

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Cerebral Hemorrhage
LDL Lipoproteins
LDL Cholesterol
Prospective Studies
Stroke
Confidence Intervals
Medical Records
Cohort Studies
Myocardial Infarction

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

Cite this

Ma, Chaoran ; Gurol, M. Edip ; Huang, Zhe ; Lichtenstein, Alice H. ; Wang, Xiuyan ; Wang, Yuzhen ; Neumann, Samantha ; Wu, Shouling ; Gao, Xiang. / Low-density lipoprotein cholesterol and risk of intracerebral hemorrhage : A prospective study. In: Neurology. 2019 ; Vol. 93, No. 5. pp. e445-e457.
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abstract = "OBJECTIVE: To prospectively examine the association between low-density lipoprotein (LDL) cholesterol (LDL-C) concentrations and intracerebral hemorrhage (ICH) risk. METHODS: The current cohort study included 96,043 participants (mean age 51.3 years) who were free of stroke, myocardial infarction, and cancer at baseline (2006). Serum LDL-C concentrations were assessed in 2006, 2008, 2010, and 2012. Cumulative average LDL-C concentrations were calculated from all available LDL-C data during that period. Incident ICH was confirmed by review of medical records. RESULTS: We identified 753 incident ICH cases during 9 years of follow-up. The ICH risk was similar among participants with LDL concentrations of 70 to 99 mg/dL and those with LDL-C concentrations ≥100 mg/dL. In contrast, participants with LDL-C concentrations <70 mg/dL had a significantly higher risk of developing ICH than those with LDL-C concentrations of 70 to 99 mg/dL; adjusted hazard ratios were 1.65 (95{\%} confidence interval [CI] 1.32-2.05) for LDL-C concentrations of 50 to 69 mg/dL and 2.69 (95{\%} CI 2.03-3.57) for LDL-C concentrations <50 mg/dL. CONCLUSIONS: We observed a significant association between lower LDL-C and higher risk of ICH when LDL-C was <70 mg/dL, and the association became nonsignificant when LDL-C ≥70 mg/dL. These data can help determination of the ideal LDL range in patients who are at increased risk of both atherosclerotic disease and hemorrhagic stroke and guide planning of future lipid-lowering studies.",
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Ma, C, Gurol, ME, Huang, Z, Lichtenstein, AH, Wang, X, Wang, Y, Neumann, S, Wu, S & Gao, X 2019, 'Low-density lipoprotein cholesterol and risk of intracerebral hemorrhage: A prospective study', Neurology, vol. 93, no. 5, pp. e445-e457. https://doi.org/10.1212/WNL.0000000000007853

Low-density lipoprotein cholesterol and risk of intracerebral hemorrhage : A prospective study. / Ma, Chaoran; Gurol, M. Edip; Huang, Zhe; Lichtenstein, Alice H.; Wang, Xiuyan; Wang, Yuzhen; Neumann, Samantha; Wu, Shouling; Gao, Xiang.

In: Neurology, Vol. 93, No. 5, 30.07.2019, p. e445-e457.

Research output: Contribution to journalArticle

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T1 - Low-density lipoprotein cholesterol and risk of intracerebral hemorrhage

T2 - A prospective study

AU - Ma, Chaoran

AU - Gurol, M. Edip

AU - Huang, Zhe

AU - Lichtenstein, Alice H.

AU - Wang, Xiuyan

AU - Wang, Yuzhen

AU - Neumann, Samantha

AU - Wu, Shouling

AU - Gao, Xiang

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N2 - OBJECTIVE: To prospectively examine the association between low-density lipoprotein (LDL) cholesterol (LDL-C) concentrations and intracerebral hemorrhage (ICH) risk. METHODS: The current cohort study included 96,043 participants (mean age 51.3 years) who were free of stroke, myocardial infarction, and cancer at baseline (2006). Serum LDL-C concentrations were assessed in 2006, 2008, 2010, and 2012. Cumulative average LDL-C concentrations were calculated from all available LDL-C data during that period. Incident ICH was confirmed by review of medical records. RESULTS: We identified 753 incident ICH cases during 9 years of follow-up. The ICH risk was similar among participants with LDL concentrations of 70 to 99 mg/dL and those with LDL-C concentrations ≥100 mg/dL. In contrast, participants with LDL-C concentrations <70 mg/dL had a significantly higher risk of developing ICH than those with LDL-C concentrations of 70 to 99 mg/dL; adjusted hazard ratios were 1.65 (95% confidence interval [CI] 1.32-2.05) for LDL-C concentrations of 50 to 69 mg/dL and 2.69 (95% CI 2.03-3.57) for LDL-C concentrations <50 mg/dL. CONCLUSIONS: We observed a significant association between lower LDL-C and higher risk of ICH when LDL-C was <70 mg/dL, and the association became nonsignificant when LDL-C ≥70 mg/dL. These data can help determination of the ideal LDL range in patients who are at increased risk of both atherosclerotic disease and hemorrhagic stroke and guide planning of future lipid-lowering studies.

AB - OBJECTIVE: To prospectively examine the association between low-density lipoprotein (LDL) cholesterol (LDL-C) concentrations and intracerebral hemorrhage (ICH) risk. METHODS: The current cohort study included 96,043 participants (mean age 51.3 years) who were free of stroke, myocardial infarction, and cancer at baseline (2006). Serum LDL-C concentrations were assessed in 2006, 2008, 2010, and 2012. Cumulative average LDL-C concentrations were calculated from all available LDL-C data during that period. Incident ICH was confirmed by review of medical records. RESULTS: We identified 753 incident ICH cases during 9 years of follow-up. The ICH risk was similar among participants with LDL concentrations of 70 to 99 mg/dL and those with LDL-C concentrations ≥100 mg/dL. In contrast, participants with LDL-C concentrations <70 mg/dL had a significantly higher risk of developing ICH than those with LDL-C concentrations of 70 to 99 mg/dL; adjusted hazard ratios were 1.65 (95% confidence interval [CI] 1.32-2.05) for LDL-C concentrations of 50 to 69 mg/dL and 2.69 (95% CI 2.03-3.57) for LDL-C concentrations <50 mg/dL. CONCLUSIONS: We observed a significant association between lower LDL-C and higher risk of ICH when LDL-C was <70 mg/dL, and the association became nonsignificant when LDL-C ≥70 mg/dL. These data can help determination of the ideal LDL range in patients who are at increased risk of both atherosclerotic disease and hemorrhagic stroke and guide planning of future lipid-lowering studies.

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