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• W4221034711 abstract "Background The relationship between serum LDL level and hemorrhagic stroke is inconclusive. Several epidemiological Studies have noted that low LDL is a risk factor for ICH, however very few studies have defined the link between LDL and hemorrhagic stroke severity. Aim We hypothesized that low serum LDL levels may have association with intracerebral hemorrhage (ICH) severity at admission and worse outcomes. Methods This retrospective study reviewed data obtained from SIREN - the largest multicenter stroke study in Africa. We categorized patients with acute spontaneous ICH based on their baseline levels of LDL measured at admission, into 4 groups: <70, 70–100, 100-125 and >125 mg/dL of LDL. We evaluated initial stroke severity, using the GCS, ICH Score, NIHSS and unfavorable outcomes using modified Rankin Scale [mRS] score. Pearson's correlation analysis was used to correlate LDL levels with indices of hemorrhagic stroke severity (GCS, NIHSS, ICH score, ICH volume, age) and a linear regression analysis was then performed. Results A total of 1162 patients with ICH (mean age 54.42±13.63 years; 62.5% men) were included in this study of which nearly all subjects 1125 (96.8%) had hypertension as a risk factor. 766 (65.9%) had fatal outcomes with mean GCS, NIHSS, ICH Score and MRS of 11.12±3.90, 16.84±11.69, 1.74±1.39 and 4.11±1.11 respectively. 992 had serum LDL assessed at admission of which 565 (56.95%) of them had baseline LDL<125 mg/dL, 427 (43.04%) had LDL >125mg/dl. Patients that died had a lower mean serum LDL level than those that survived (121.19±47.60 vs 125.17±53.56), although not statistically significant (P= 0.275). The percentage of men with serum LDL levels <70mg/dl (70.6%), 70-100mg/dl (62.1%), >100mg/dl (66%) was significantly higher than that of men with LDL >125mg/dl (57.6%) - (P = 0.030). In a similar vein, patients with LDL <70 mg/dl were younger (mean age: 52.43±13.06) than those with LDL 70-100, 100-125, >125 who had mean age±SD 53.78±13.73, 56.74±13.26, 53.59±13.00 respectively (P:0.011). As expected, the cohort of patients with LDL <70 had a lower BMI (25.59±4.59) as compared with those with LDL >125mg/dl BMI: 27.06±5.27 (P value 0.017). The presence of hypertension as a risk factor among the 4 different LDL sub-categories was not statistically significant (p = 0.648). Interestingly, patients with LDL <70 mg/dL presented with more severe stroke, with a mean GCS±SD of 9.46±3.77 when compared with patients with LDL of 70-100, 100-125, >125 who had a mean GCS 11.42±3.75, 10.11±4.30 and 11.79±3.73 respectively (P-value: 0.007). In the correlation analysis, there was a positive correlation between LDL levels and the GCS (P value: 0.014) and a negative correlation between LDL and the ICH score as well as the NIHSS score at baseline, although not statistically significant. Conclusion Mortality of ICH remains high in Africa. LDL<125mg/dl is more common in African subjects with ICH and those with LDL <70mg/dl happened to be much younger men with a good metabolic profile. LDL level < 70 mg/dL was associated with worse Glasgow Coma Score at presentation. A follow up study on the association between LDL levels and hematoma volume is imperative as it may explain this association. The relationship between serum LDL level and hemorrhagic stroke is inconclusive. Several epidemiological Studies have noted that low LDL is a risk factor for ICH, however very few studies have defined the link between LDL and hemorrhagic stroke severity. We hypothesized that low serum LDL levels may have association with intracerebral hemorrhage (ICH) severity at admission and worse outcomes. This retrospective study reviewed data obtained from SIREN - the largest multicenter stroke study in Africa. We categorized patients with acute spontaneous ICH based on their baseline levels of LDL measured at admission, into 4 groups: <70, 70–100, 100-125 and >125 mg/dL of LDL. We evaluated initial stroke severity, using the GCS, ICH Score, NIHSS and unfavorable outcomes using modified Rankin Scale [mRS] score. Pearson's correlation analysis was used to correlate LDL levels with indices of hemorrhagic stroke severity (GCS, NIHSS, ICH score, ICH volume, age) and a linear regression analysis was then performed. A total of 1162 patients with ICH (mean age 54.42±13.63 years; 62.5% men) were included in this study of which nearly all subjects 1125 (96.8%) had hypertension as a risk factor. 766 (65.9%) had fatal outcomes with mean GCS, NIHSS, ICH Score and MRS of 11.12±3.90, 16.84±11.69, 1.74±1.39 and 4.11±1.11 respectively. 992 had serum LDL assessed at admission of which 565 (56.95%) of them had baseline LDL<125 mg/dL, 427 (43.04%) had LDL >125mg/dl. Patients that died had a lower mean serum LDL level than those that survived (121.19±47.60 vs 125.17±53.56), although not statistically significant (P= 0.275). The percentage of men with serum LDL levels <70mg/dl (70.6%), 70-100mg/dl (62.1%), >100mg/dl (66%) was significantly higher than that of men with LDL >125mg/dl (57.6%) - (P = 0.030). In a similar vein, patients with LDL <70 mg/dl were younger (mean age: 52.43±13.06) than those with LDL 70-100, 100-125, >125 who had mean age±SD 53.78±13.73, 56.74±13.26, 53.59±13.00 respectively (P:0.011). As expected, the cohort of patients with LDL <70 had a lower BMI (25.59±4.59) as compared with those with LDL >125mg/dl BMI: 27.06±5.27 (P value 0.017). The presence of hypertension as a risk factor among the 4 different LDL sub-categories was not statistically significant (p = 0.648). Interestingly, patients with LDL <70 mg/dL presented with more severe stroke, with a mean GCS±SD of 9.46±3.77 when compared with patients with LDL of 70-100, 100-125, >125 who had a mean GCS 11.42±3.75, 10.11±4.30 and 11.79±3.73 respectively (P-value: 0.007). In the correlation analysis, there was a positive correlation between LDL levels and the GCS (P value: 0.014) and a negative correlation between LDL and the ICH score as well as the NIHSS score at baseline, although not statistically significant. Mortality of ICH remains high in Africa. LDL<125mg/dl is more common in African subjects with ICH and those with LDL <70mg/dl happened to be much younger men with a good metabolic profile. LDL level < 70 mg/dL was associated with worse Glasgow Coma Score at presentation. A follow up study on the association between LDL levels and hematoma volume is imperative as it may explain this association." @default.
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• W4221034711 date "2022-04-01" @default.
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• W4221034711 title "CORRELATION BETWEEN SERUM LOW DENSITY LIPOPROTEIN (LDL) LEVELS AND HEMORRHAGIC STROKE SEVERITY: A RETROSPECTIVE REVIEW (PRELIMINARY FINDINGS)" @default.
• W4221034711 doi "https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106362" @default.
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