Abstract T P311: Lipid Profile and Clinical Outcomes in Acute Intracerebral Hemorrhage: The SAMURAI-ICH Study

Abstract

Background and purpose: Although low serum total cholesterol (TC) levels are associated with an increased risk of intracerebral hemorrhage (ICH), the prognostic value of lipid parameters is not fully known. We aimed to determine the association between lipid parameters on admission and clinical outcomes in acute ICH patients. Methods: This study is a post-hoc analysis of the SAMURAI-ICH study, which was a prospective, multicenter, observational study. Hyperacute (hospitalized <3 hours from onset) ICH patients were included. Serum TC, triglyceride (TG), high-density lipoprotein cholesterol (HDLC) and low-density lipoprotein cholesterol (LDLC) were measured on admission. Clinical outcomes were hematoma expansion (>33% increase), neurological deterioration (a decrease of ≥2 in GCS or an increase of ≥4 in NIHSS from baseline to 72 hours), favorable outcome (3-month mRS 0-2) and unfavorable outcome (3-month mRS 4-6). Results: Of the 204 patients (78 women; 66±12 years; median baseline NIHSS, 13 [8-17]), a statin was prescribed in 16 (8%). Of all, 35 (17%) showed hematoma expansion, 16 (8%) experienced neurological deterioration, and 80 (of 199 with premorbid mRS 0-2, 40%) and 84 (41%) had favorable and unfavorable outcomes, respectively. Levels of TC, TG, HDLC and LDLC were 196±40, 125±69, 59±17and 112±34mg/dl, respectively. On multivariate regression analyses adjusted for established prognostic predictors, TG (odds ratio per 10mg/dl [OR], 1.06; 95% confidence interval [CI], 1.002-1.13; p=0.042) was associated with hematoma expansion, and HDLC (OR, 1.30; 95% CI, 1.04-1.65; p=0.024) was positively, and LDLC (OR, 0.89; 95% CI, 0.80-0.999; p=0.048) was inversely associated with favorable outcome. Although prior statin use was not associated with any clinical outcomes, HDLC (OR, 1.20; 95% CI, 0.95-1.53; p=0.123) and LDLC (OR, 0.90; 95% CI, 0.79-1.01; p=0.071) were no more significantly associated with favorable outcome after excluding patients with prior statin. No parameters were significantly associated with neurological deterioration and unfavorable outcome. Conclusions: High TG level was associated with hematoma expansion. High HDLC and low LDLC levels were associated with independence at 3 months after onset in patients with acute ICH.