Abstract TP305: Lower Serum Total Cholesterol Levels Are Associated With Increased Severity of Intracerebral Hemorrhage: Results from the Taiwan Stroke Registry

Abstract

Background and Purpose: Evidence of a causal relationship between serum cholesterol level and hemorrhagic stroke is inconclusive. We hypothesized that lower total serum cholesterol (TC) levels are associated with severe intracerebral hemorrhage (ICH). Methods: During May, 2006 and April, 2009, patients registered in the Taiwan Stroke Registry, a prospective registry engaging 38 academic and community hospitals across Taiwan (Hsie FI et al, Circulation, 2010), and who had first-ever spontaneous ICH were included. Patients who did not have measure of TC at baseline were excluded. Lower TC was defined as the serum level of TC <160 mg/dl. Stroke severity measured by the National Institutes of Health Stroke Scale (NIHSS) was dichotomized (score >15 versus ≤15). Mortality and poor functional outcome (modified Rankin Scale score >2) at 1 month were collected. Multivariable logistic regression analysis was used to determine the association between lower TC and initial severity of ICH. Results: A total of 2239 ICH patients (mean age 62±14 years, 64% men) were included in this analysis. There were 774 (34.6%) patients presented with lower TC on admission. Lower TC levels at baseline was significantly associated with higher baseline NIHSS >15 (odds ratio, 1.78; 95% CI, 1.44 to 2.19). One-month case-fatality was higher in patients with low TC than those without (9.2% vs. 5.1%, P=0.0002). Prior use of lipid-lowering drugs was not associated with low TC or not. Conclusion: A lower total cholesterol level was associated with increased severity of ICH at presentation.