Key result
Low levels of LDL-C and total cholesterol are associated with intracerebral hemorrhage, suggesting a cautious approach to aggressive LDL reduction in high-risk patients.
Why the study?
Guidelines increasingly lower LDL-C goals, but data point towards an association between low LDL-C, total cholesterol, and intracerebral hemorrhage.
Does aggressive LDL-C reduction increase the risk of intracerebral hemorrhage?
Does aggressive LDL-C reduction increase the risk of intracerebral hemorrhage?
While guidelines continue to lower optimal LDL-C targets, aggressive lipid lowering may increase the risk of intracerebral hemorrhage, warranting individualized therapy in high-risk patients.
May warrant caution with very low LDL-C targets in ICH-prone patients; leaves open need for prospective trials to guide practice.
Excessive levels of low-density lipoprotein cholesterol (LDL-C) in the blood are a known risk factor for atherosclerosis, and a common target of treatment for primary and secondary prevention of cerebrocardiovascular disease. As lipid lowering agents including statins, ezetimibe and anti-proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have shown good therapeutic results, the guidelines are constantly lowering the "optimal" LDL-C goals. However, old and new data point towards an association between low LDL-C and total cholesterol and intracerebral hemorrhage (ICH). In this review we aimed to shed light on this troubling association and identify the potential risk factors of such a potential adverse reaction. With respect to the data presented, we concluded that in patients with high risk of ICH, a cautious approach and individualized therapy strategy are advised when considering aggressive LDL reduction.
No takes yet. Share an insight, caveat, or question.
Gurevitz et al. (2022) conducted a review in Intracerebral hemorrhage. Low levels of low-density lipoprotein cholesterol was evaluated on Intracerebral hemorrhage. Low levels of LDL-C and total cholesterol are associated with intracerebral hemorrhage, suggesting a cautious approach to aggressive LDL reduction in high-risk patients.