Low cholesterol level associated with severity and outcome of spontaneous intracerebral hemorrhage: Results from Taiwan Stroke Registry

Wei Yu Chen, Chen Hua Li, Chih Dong Yang, Chung Hsiang Liu, Chih Hung Chen, Jau Jiuan Sheu, Shinn Kuang Lin, An Chih Chen, Ping Kun Chen, Po Lin Chen, Chung Hsin Yeh, Jiunn Rong Chen, Yu Jen Hsiao, Ching Huang Lin, Shih Pin Hsu, Tsang Shan Chen, Sheng Feng Sung, Shih Chieh Yu, Chih Hsin Muo, Chi Pang WenFung Chang Sung, Jiann Shing Jeng, Chung Y. Hsu

Research output: Contribution to journalArticle

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Abstract

The relationship between cholesterol level and hemorrhagic stroke is inconclusive. We hypothesized that low cholesterol levels may have association with intracerebral hemorrhage (ICH) severity at admission and 3-month outcomes. This study used data obtained from a multi-center stroke registry program in Taiwan. We categorized acute spontaneous ICH patients, based on their baseline levels of total cholesterol (TC) measured at admission, into 3 groups with <160, 160±200 and >200 mg/dL of TC. We evaluated risk of having initial stroke severity, with National Institutes of Health Stroke Scale (NIHSS) >15 and unfavorable outcomes (modified Rankin Scale [mRS] score >2, 3-month mortality) after ICH by the TC group. A total of 2444 ICH patients (mean age 62.5±14.2 years; 64.2% men) were included in this study and 854 (34.9%) of them had baseline TC <160 mg/dL. Patients with TC <160 mg/dL presented more often severe neurological deficit (NIHSS >15), with an adjusted odds ratio [aOR] of 1.80; 95% confidence interval [CI], 1.41±2.30), and 3-month mRS >2 (aOR, 1.41; 95% CI, 1.11±1.78) using patients with TC >200 mg/dL as reference. Those with TC >160 mg/dL and body mass index (BMI) <22 kg/m2 had higher risk of 3-month mortality (aOR 3.94, 95% CI 1.76±8.80). Prior use of lipid-lowering drugs (2.8% of the ICH population) was not associated with initial severity and 3-month outcomes. A total cholesterol level lower than 160 mg/dL was common in patients with acute ICH and was associated with greater neurological severity on presentation and poor 3-month outcomes, especially with lower BMI.

Original languageEnglish
Article numbere0171379
JournalPLoS One
Volume12
Issue number4
DOIs
Publication statusPublished - Apr 1 2017

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Cerebral Hemorrhage
Taiwan
stroke
hemorrhage
Registries
Stroke
Cholesterol
cholesterol
odds ratio
confidence interval
Odds Ratio
Confidence Intervals
body mass index
Body Mass Index
National Institutes of Health
Mortality
National Institutes of Health (U.S.)
Health
Lipids
drugs

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Low cholesterol level associated with severity and outcome of spontaneous intracerebral hemorrhage : Results from Taiwan Stroke Registry. / Chen, Wei Yu; Li, Chen Hua; Yang, Chih Dong; Liu, Chung Hsiang; Chen, Chih Hung; Sheu, Jau Jiuan; Lin, Shinn Kuang; Chen, An Chih; Chen, Ping Kun; Chen, Po Lin; Yeh, Chung Hsin; Chen, Jiunn Rong; Hsiao, Yu Jen; Lin, Ching Huang; Hsu, Shih Pin; Chen, Tsang Shan; Sung, Sheng Feng; Yu, Shih Chieh; Muo, Chih Hsin; Wen, Chi Pang; Sung, Fung Chang; Jeng, Jiann Shing; Hsu, Chung Y.

In: PLoS One, Vol. 12, No. 4, e0171379, 01.04.2017.

Research output: Contribution to journalArticle

Chen, WY, Li, CH, Yang, CD, Liu, CH, Chen, CH, Sheu, JJ, Lin, SK, Chen, AC, Chen, PK, Chen, PL, Yeh, CH, Chen, JR, Hsiao, YJ, Lin, CH, Hsu, SP, Chen, TS, Sung, SF, Yu, SC, Muo, CH, Wen, CP, Sung, FC, Jeng, JS & Hsu, CY 2017, 'Low cholesterol level associated with severity and outcome of spontaneous intracerebral hemorrhage: Results from Taiwan Stroke Registry', PLoS One, vol. 12, no. 4, e0171379. https://doi.org/10.1371/journal.pone.0171379
Chen, Wei Yu ; Li, Chen Hua ; Yang, Chih Dong ; Liu, Chung Hsiang ; Chen, Chih Hung ; Sheu, Jau Jiuan ; Lin, Shinn Kuang ; Chen, An Chih ; Chen, Ping Kun ; Chen, Po Lin ; Yeh, Chung Hsin ; Chen, Jiunn Rong ; Hsiao, Yu Jen ; Lin, Ching Huang ; Hsu, Shih Pin ; Chen, Tsang Shan ; Sung, Sheng Feng ; Yu, Shih Chieh ; Muo, Chih Hsin ; Wen, Chi Pang ; Sung, Fung Chang ; Jeng, Jiann Shing ; Hsu, Chung Y. / Low cholesterol level associated with severity and outcome of spontaneous intracerebral hemorrhage : Results from Taiwan Stroke Registry. In: PLoS One. 2017 ; Vol. 12, No. 4.
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abstract = "The relationship between cholesterol level and hemorrhagic stroke is inconclusive. We hypothesized that low cholesterol levels may have association with intracerebral hemorrhage (ICH) severity at admission and 3-month outcomes. This study used data obtained from a multi-center stroke registry program in Taiwan. We categorized acute spontaneous ICH patients, based on their baseline levels of total cholesterol (TC) measured at admission, into 3 groups with <160, 160±200 and >200 mg/dL of TC. We evaluated risk of having initial stroke severity, with National Institutes of Health Stroke Scale (NIHSS) >15 and unfavorable outcomes (modified Rankin Scale [mRS] score >2, 3-month mortality) after ICH by the TC group. A total of 2444 ICH patients (mean age 62.5±14.2 years; 64.2{\%} men) were included in this study and 854 (34.9{\%}) of them had baseline TC <160 mg/dL. Patients with TC <160 mg/dL presented more often severe neurological deficit (NIHSS >15), with an adjusted odds ratio [aOR] of 1.80; 95{\%} confidence interval [CI], 1.41±2.30), and 3-month mRS >2 (aOR, 1.41; 95{\%} CI, 1.11±1.78) using patients with TC >200 mg/dL as reference. Those with TC >160 mg/dL and body mass index (BMI) <22 kg/m2 had higher risk of 3-month mortality (aOR 3.94, 95{\%} CI 1.76±8.80). Prior use of lipid-lowering drugs (2.8{\%} of the ICH population) was not associated with initial severity and 3-month outcomes. A total cholesterol level lower than 160 mg/dL was common in patients with acute ICH and was associated with greater neurological severity on presentation and poor 3-month outcomes, especially with lower BMI.",
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T1 - Low cholesterol level associated with severity and outcome of spontaneous intracerebral hemorrhage

T2 - Results from Taiwan Stroke Registry

AU - Chen, Wei Yu

AU - Li, Chen Hua

AU - Yang, Chih Dong

AU - Liu, Chung Hsiang

AU - Chen, Chih Hung

AU - Sheu, Jau Jiuan

AU - Lin, Shinn Kuang

AU - Chen, An Chih

AU - Chen, Ping Kun

AU - Chen, Po Lin

AU - Yeh, Chung Hsin

AU - Chen, Jiunn Rong

AU - Hsiao, Yu Jen

AU - Lin, Ching Huang

AU - Hsu, Shih Pin

AU - Chen, Tsang Shan

AU - Sung, Sheng Feng

AU - Yu, Shih Chieh

AU - Muo, Chih Hsin

AU - Wen, Chi Pang

AU - Sung, Fung Chang

AU - Jeng, Jiann Shing

AU - Hsu, Chung Y.

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N2 - The relationship between cholesterol level and hemorrhagic stroke is inconclusive. We hypothesized that low cholesterol levels may have association with intracerebral hemorrhage (ICH) severity at admission and 3-month outcomes. This study used data obtained from a multi-center stroke registry program in Taiwan. We categorized acute spontaneous ICH patients, based on their baseline levels of total cholesterol (TC) measured at admission, into 3 groups with <160, 160±200 and >200 mg/dL of TC. We evaluated risk of having initial stroke severity, with National Institutes of Health Stroke Scale (NIHSS) >15 and unfavorable outcomes (modified Rankin Scale [mRS] score >2, 3-month mortality) after ICH by the TC group. A total of 2444 ICH patients (mean age 62.5±14.2 years; 64.2% men) were included in this study and 854 (34.9%) of them had baseline TC <160 mg/dL. Patients with TC <160 mg/dL presented more often severe neurological deficit (NIHSS >15), with an adjusted odds ratio [aOR] of 1.80; 95% confidence interval [CI], 1.41±2.30), and 3-month mRS >2 (aOR, 1.41; 95% CI, 1.11±1.78) using patients with TC >200 mg/dL as reference. Those with TC >160 mg/dL and body mass index (BMI) <22 kg/m2 had higher risk of 3-month mortality (aOR 3.94, 95% CI 1.76±8.80). Prior use of lipid-lowering drugs (2.8% of the ICH population) was not associated with initial severity and 3-month outcomes. A total cholesterol level lower than 160 mg/dL was common in patients with acute ICH and was associated with greater neurological severity on presentation and poor 3-month outcomes, especially with lower BMI.

AB - The relationship between cholesterol level and hemorrhagic stroke is inconclusive. We hypothesized that low cholesterol levels may have association with intracerebral hemorrhage (ICH) severity at admission and 3-month outcomes. This study used data obtained from a multi-center stroke registry program in Taiwan. We categorized acute spontaneous ICH patients, based on their baseline levels of total cholesterol (TC) measured at admission, into 3 groups with <160, 160±200 and >200 mg/dL of TC. We evaluated risk of having initial stroke severity, with National Institutes of Health Stroke Scale (NIHSS) >15 and unfavorable outcomes (modified Rankin Scale [mRS] score >2, 3-month mortality) after ICH by the TC group. A total of 2444 ICH patients (mean age 62.5±14.2 years; 64.2% men) were included in this study and 854 (34.9%) of them had baseline TC <160 mg/dL. Patients with TC <160 mg/dL presented more often severe neurological deficit (NIHSS >15), with an adjusted odds ratio [aOR] of 1.80; 95% confidence interval [CI], 1.41±2.30), and 3-month mRS >2 (aOR, 1.41; 95% CI, 1.11±1.78) using patients with TC >200 mg/dL as reference. Those with TC >160 mg/dL and body mass index (BMI) <22 kg/m2 had higher risk of 3-month mortality (aOR 3.94, 95% CI 1.76±8.80). Prior use of lipid-lowering drugs (2.8% of the ICH population) was not associated with initial severity and 3-month outcomes. A total cholesterol level lower than 160 mg/dL was common in patients with acute ICH and was associated with greater neurological severity on presentation and poor 3-month outcomes, especially with lower BMI.

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