TY - JOUR
T1 - Serum cholesterol levels, HMG-CoA reductase inhibitors and the risk of intracerebral haemorrhage. The Multicenter Study on Cerebral Haemorrhage in Italy (MUCH-Italy)
AU - Pezzini, Alessandro
AU - Grassi, Mario
AU - Iacoviello, Licia
AU - Zedde, Marialuisa
AU - Marcheselli, Simona
AU - Silvestrelli, Giorgio
AU - DeLodovici, Maria Luisa
AU - Sessa, Maria
AU - Zini, Andrea
AU - Paciaroni, Maurizio
AU - Azzini, Cristiano
AU - Gamba, Massimo
AU - Del Sette, Massimo
AU - Toriello, Antonella
AU - Gandolfo, Carlo
AU - Bonifati, Domenico Marco
AU - Tassi, Rossana
AU - Cavallini, Anna
AU - Chiti, Alberto
AU - Calabrò, Rocco Salvatore
AU - Musolino, Rossella
AU - Bovi, Paolo
AU - Tomelleri, Giampaolo
AU - Di Castelnuovo, Augusto
AU - Vandelli, Laura
AU - Ritelli, Marco
AU - Agnelli, Giancarlo
AU - De Vito, Alessandro
AU - Pugliese, Nicola
AU - Martini, Giuseppe
AU - Lanari, Alessia
AU - Ciccone, Alfonso
AU - Lodigiani, Corrado
AU - Malferrari, Giovanni
AU - Del Zotto, Elisabetta
AU - Morotti, Andrea
AU - Costa, Paolo
AU - Poli, Loris
AU - De Giuli, Valeria
AU - Bonaiti, Silvia
AU - La Spina, Paolo
AU - Marcello, Norina
AU - Micieli, Giuseppe
AU - de Gaetano, Giovanni
AU - Colombi, Marina
AU - Padovani, Alessandro
PY - 2016/3/21
Y1 - 2016/3/21
N2 - Objective Although a concern exists that 3-hydroxy-3- methylglutaryl coenzyme A reductase inhibitors (statins) might increase the risk of intracerebral haemorrhage (ICH), the contribution of these agents to the relationship between serum cholesterol and disease occurrence has been poorly investigated. Methods We compared consecutive patients having ICH with age and sex-matched stroke-free control subjects in a case-control analysis, as part of the Multicenter Study on Cerebral Haemorrhage in Italy (MUCH-Italy), and tested the presence of interaction effects between total serum cholesterol levels and statins on the risk of ICH. Results A total of 3492 cases (mean age, 73.0 ±12.7 years; males, 56.6%) and 3492 control subjects were enrolled. Increasing total serum cholesterol levels were confirmed to be inversely associated with ICH. We observed a statistical interaction between total serum cholesterol levels and statin use for the risk of haemorrhage (Interaction OR (IOR), 1.09; 95% CI 1.05 to 1.12). Increasing levels of total serum cholesterol were associated with a decreased risk of ICH within statin strata (average OR, 0.87; 95% CI 0.86 to 0.88 for every increase of 0.26 mmol/l of total serum cholesterol concentrations), while statin use was associated with an increased risk (OR, 1.54; 95% CI 1.31 to 1.81 of the average level of total serum cholesterol). The protective effect of serum cholesterol against ICH was reduced by statins in strictly lobar brain regions more than in non-lobar ones. Conclusions Statin therapy and total serum cholesterol levels exhibit interaction effects towards the risk of ICH. The magnitude of such effects appears higher in lobar brain regions.
AB - Objective Although a concern exists that 3-hydroxy-3- methylglutaryl coenzyme A reductase inhibitors (statins) might increase the risk of intracerebral haemorrhage (ICH), the contribution of these agents to the relationship between serum cholesterol and disease occurrence has been poorly investigated. Methods We compared consecutive patients having ICH with age and sex-matched stroke-free control subjects in a case-control analysis, as part of the Multicenter Study on Cerebral Haemorrhage in Italy (MUCH-Italy), and tested the presence of interaction effects between total serum cholesterol levels and statins on the risk of ICH. Results A total of 3492 cases (mean age, 73.0 ±12.7 years; males, 56.6%) and 3492 control subjects were enrolled. Increasing total serum cholesterol levels were confirmed to be inversely associated with ICH. We observed a statistical interaction between total serum cholesterol levels and statin use for the risk of haemorrhage (Interaction OR (IOR), 1.09; 95% CI 1.05 to 1.12). Increasing levels of total serum cholesterol were associated with a decreased risk of ICH within statin strata (average OR, 0.87; 95% CI 0.86 to 0.88 for every increase of 0.26 mmol/l of total serum cholesterol concentrations), while statin use was associated with an increased risk (OR, 1.54; 95% CI 1.31 to 1.81 of the average level of total serum cholesterol). The protective effect of serum cholesterol against ICH was reduced by statins in strictly lobar brain regions more than in non-lobar ones. Conclusions Statin therapy and total serum cholesterol levels exhibit interaction effects towards the risk of ICH. The magnitude of such effects appears higher in lobar brain regions.
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U2 - 10.1136/jnnp-2015-312736
DO - 10.1136/jnnp-2015-312736
M3 - Article
AN - SCOPUS:84962784403
JO - Journal of Neurology, Neurosurgery and Psychiatry
JF - Journal of Neurology, Neurosurgery and Psychiatry
SN - 0022-3050
ER -