Low Remnant Cholesterol and In‐Hospital Bleeding Risk After Ischemic Stroke or Transient Ischemic Attack
Background Bleeding risk brought by intensive lipid‐lowering therapy and low low‐density lipoprotein cholesterol is concerning, while evidence regarding the relationship between remnant cholesterol and bleeding is frightening. This study aimed to investigate the association between remnant cholester...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-07-01
|
| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.034307 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850276417682538496 |
|---|---|
| author | Zhiyuan Wu Haiping Zhang Yi Xu Xia Li Xingang Li Lois Balmer Xiuhua Guo Qi Zhang Xiang Han Lixin Tao |
| author_facet | Zhiyuan Wu Haiping Zhang Yi Xu Xia Li Xingang Li Lois Balmer Xiuhua Guo Qi Zhang Xiang Han Lixin Tao |
| author_sort | Zhiyuan Wu |
| collection | DOAJ |
| description | Background Bleeding risk brought by intensive lipid‐lowering therapy and low low‐density lipoprotein cholesterol is concerning, while evidence regarding the relationship between remnant cholesterol and bleeding is frightening. This study aimed to investigate the association between remnant cholesterol at admission and an in‐hospital bleeding event after acute ischemic stroke or transient ischemic attack (TIA). Methods and Results A total of 3222 eligible patients admitted to Shanghai Huashan Hospital between 2015 and 2021 with complete lipid data were analyzed. Patients were classified into low (<20.0 mg/dL), moderate (20.0–29.9 mg/dL), and high (≥30 mg/dL) groups by remnant cholesterol. The mean age of patients was 63.0± 13.1 years, including 2301 (71.4%) men and 651 (20.2%) with TIA. The median (interquartile range) of remnant cholesterol was 18.6 (13.5–25.9) mg/dL. After adjustment for confounding variables, patients with low remnant cholesterol had a higher risk of bleeding events (odds ratio, 2.56 [95% CI, 1.12–6.67]) than those with moderate remnant cholesterol. The high remnant cholesterol group was not significantly associated with bleeding risk. Combined assessment of low‐density lipoprotein cholesterol and remnant cholesterol further identified patients with the highest risk of bleeding events. Conclusions Low remnant cholesterol levels were associated with bleeding events during the acute stage of ischemic stroke and TIA. The assessment of remnant cholesterol could inform the bleeding risk during hospitalization both for patients and physicians in clinical practice. |
| format | Article |
| id | doaj-art-d244b271a60a45fe97f4fcc7e374834f |
| institution | OA Journals |
| issn | 2047-9980 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-d244b271a60a45fe97f4fcc7e374834f2025-08-20T01:50:18ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-07-01131410.1161/JAHA.124.034307Low Remnant Cholesterol and In‐Hospital Bleeding Risk After Ischemic Stroke or Transient Ischemic AttackZhiyuan Wu0Haiping Zhang1Yi Xu2Xia Li3Xingang Li4Lois Balmer5Xiuhua Guo6Qi Zhang7Xiang Han8Lixin Tao9Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health Capital Medical University Beijing ChinaBeijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health Capital Medical University Beijing ChinaHuashan Hospital Fudan University Shanghai ChinaDepartment of Mathematics and Statistics La Trobe University Melbourne AustraliaCentre for Precision Health, School of Medical and Health Sciences Edith Cowan University Joondalup AustraliaCentre for Precision Health, School of Medical and Health Sciences Edith Cowan University Joondalup AustraliaBeijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health Capital Medical University Beijing ChinaHuashan Hospital Fudan University Shanghai ChinaHuashan Hospital Fudan University Shanghai ChinaBeijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health Capital Medical University Beijing ChinaBackground Bleeding risk brought by intensive lipid‐lowering therapy and low low‐density lipoprotein cholesterol is concerning, while evidence regarding the relationship between remnant cholesterol and bleeding is frightening. This study aimed to investigate the association between remnant cholesterol at admission and an in‐hospital bleeding event after acute ischemic stroke or transient ischemic attack (TIA). Methods and Results A total of 3222 eligible patients admitted to Shanghai Huashan Hospital between 2015 and 2021 with complete lipid data were analyzed. Patients were classified into low (<20.0 mg/dL), moderate (20.0–29.9 mg/dL), and high (≥30 mg/dL) groups by remnant cholesterol. The mean age of patients was 63.0± 13.1 years, including 2301 (71.4%) men and 651 (20.2%) with TIA. The median (interquartile range) of remnant cholesterol was 18.6 (13.5–25.9) mg/dL. After adjustment for confounding variables, patients with low remnant cholesterol had a higher risk of bleeding events (odds ratio, 2.56 [95% CI, 1.12–6.67]) than those with moderate remnant cholesterol. The high remnant cholesterol group was not significantly associated with bleeding risk. Combined assessment of low‐density lipoprotein cholesterol and remnant cholesterol further identified patients with the highest risk of bleeding events. Conclusions Low remnant cholesterol levels were associated with bleeding events during the acute stage of ischemic stroke and TIA. The assessment of remnant cholesterol could inform the bleeding risk during hospitalization both for patients and physicians in clinical practice.https://www.ahajournals.org/doi/10.1161/JAHA.124.034307bleedingischemic strokeremnant cholesteroltransient ischemic attack (TIA) |
| spellingShingle | Zhiyuan Wu Haiping Zhang Yi Xu Xia Li Xingang Li Lois Balmer Xiuhua Guo Qi Zhang Xiang Han Lixin Tao Low Remnant Cholesterol and In‐Hospital Bleeding Risk After Ischemic Stroke or Transient Ischemic Attack Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease bleeding ischemic stroke remnant cholesterol transient ischemic attack (TIA) |
| title | Low Remnant Cholesterol and In‐Hospital Bleeding Risk After Ischemic Stroke or Transient Ischemic Attack |
| title_full | Low Remnant Cholesterol and In‐Hospital Bleeding Risk After Ischemic Stroke or Transient Ischemic Attack |
| title_fullStr | Low Remnant Cholesterol and In‐Hospital Bleeding Risk After Ischemic Stroke or Transient Ischemic Attack |
| title_full_unstemmed | Low Remnant Cholesterol and In‐Hospital Bleeding Risk After Ischemic Stroke or Transient Ischemic Attack |
| title_short | Low Remnant Cholesterol and In‐Hospital Bleeding Risk After Ischemic Stroke or Transient Ischemic Attack |
| title_sort | low remnant cholesterol and in hospital bleeding risk after ischemic stroke or transient ischemic attack |
| topic | bleeding ischemic stroke remnant cholesterol transient ischemic attack (TIA) |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.034307 |
| work_keys_str_mv | AT zhiyuanwu lowremnantcholesterolandinhospitalbleedingriskafterischemicstrokeortransientischemicattack AT haipingzhang lowremnantcholesterolandinhospitalbleedingriskafterischemicstrokeortransientischemicattack AT yixu lowremnantcholesterolandinhospitalbleedingriskafterischemicstrokeortransientischemicattack AT xiali lowremnantcholesterolandinhospitalbleedingriskafterischemicstrokeortransientischemicattack AT xingangli lowremnantcholesterolandinhospitalbleedingriskafterischemicstrokeortransientischemicattack AT loisbalmer lowremnantcholesterolandinhospitalbleedingriskafterischemicstrokeortransientischemicattack AT xiuhuaguo lowremnantcholesterolandinhospitalbleedingriskafterischemicstrokeortransientischemicattack AT qizhang lowremnantcholesterolandinhospitalbleedingriskafterischemicstrokeortransientischemicattack AT xianghan lowremnantcholesterolandinhospitalbleedingriskafterischemicstrokeortransientischemicattack AT lixintao lowremnantcholesterolandinhospitalbleedingriskafterischemicstrokeortransientischemicattack |