226 Scientific Programme 22. European Stroke Conference © 2013 S. Karger AG, Basel 12 Stroke prognosis Prior Statin Use and Lipid Levels in Outcome of Intracerebral Hemorrhage S. Mustanoja1, D. Strbian2, J. Putaala3, A. Meretoja4, S. Curtze5, E. Haapaniemi6, T. Sairanen7, R. Hietikko8, M. Kaste9, T. Tatlisumak10 Department of Neurology, Helsinki University Central Hospital, Helsinki, FINLAND1, De-partment of Neurology, Helsinki University Central Hospital, Helsinki, FINLAND2, Department of Neurology, Helsinki University Central Hospital, Helsinki, FINLAND3, Department of Neurology, Helsinki University Central Hospital, Helsinki, FINLAND4, Department of Neurology, Helsinki University Central Hospital, Helsinki, FINLAND5, Department of Neurology, Helsinki Universi-ty Central Hospital, Helsinki, FINLAND6, Department of Neurology, Helsinki University Central Hospital, Helsinki, FINLAND7, Department of Neurology, Helsinki University Central Hospital, Helsinki, FINLAND8, Department of Neurology, Helsinki University Central Hospital, Helsinki, FINLAND9, Department of Neurology, Helsinki University Central Hospital, Helsinki, FINLAND10 Background and Purpose: We aimed to clarify the controversy of whether statin use prior to intra-cerebral hemorrhage (ICH) affects outcome, or whether blood lipid profiles are associated with the outcome of ICH. Methods: A single-center observational registry of ICH patients was used to study associations be-tween statin use, baseline lipid levels and the clinical outcome. The study cohort was divided into three groups; in statin users, nonusers with low cholesterol levels, and nonusers with high cholester-ol levels. Results: We included 521 ICH patients with data on premorbid statin use and known lipid levels in this retrospective study. There were 96 patients (18%) using statins prior to ICH, and 216 nonusers (42%) with cholesterol >/=4.5mmol/L and 209 patients (40%) >4.5mmol/L. Statin users were sig-nificantly older (median 74 years; IQR 64-79) than nonusers in the two groups (65; 57-76 and 65; 57-75 respectively, P <0.001. Statin users had more comorbidities, prior cardiovascular medica-tion, and lower lipid levels (median 4.0, 3.9 and 5.1 for the three groups respectively; P <0.001), but equally severe ICHs (median baseline NIHSS 7, 9, 7; P >0.05). In-hospital, 3-month and 12-month mortalities were significantly increased among statin users and nonusers with low cholesterol levels compared to nonusers with high cholesterol levels (P<0.05). The lower cholesterol levels did not, however, predict mortality after adjusting for ICH prognostic factors (age, NIHSS, GCS, ICH vol-ume and intraventricular location), at any time points analyzed (P>0.1). Conclusions: Prior statin use did not affect the outcome of ICH. Patients having lower cholesterol levels had increased mortality, but the association was not significant after adjusting for ICH prog-nostic factors. 11 Stroke prognosis Biomarkers associated with 90-day mortality in patients with intracerebral haemorrhage (ICH) M. Florczak-Rzepka1, Th. Steiner2 on behalf of VISTA Collaboration Department of Neurology, Medical University of Warsaw, Poland, Warsaw, POLAND1, Depart-ment of Neurology, Klinikum Frankfurt Höchst, Universitätsklinikum Heidelberg, Germany, Frank-furt, GERMANY2 Background: The course and prognosis of ICH was shown to be associated with several clinical and radiological parameters. The role of biomarkers seems to be important as regard this issue, never-theless data are inconclusive. We sought to determine biomarkers associated with case fatality three moths after ICH. Methods: We performed a nonparametric analysis of database from clinical trials on ICH including 384 patients from placebo arm. Following biomarkers measured in patients blood on admission were analysed: glucose, sodium, creatinine, troponin, leucocytes, fibrinogen, interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-alpha), matrix metalloproteinases 3 and 9 (MMP-3, MMP-9), intracel-lular adhesion molecule (ICAM) and glial fibrillary acidic protein (GFAP). These biomarkers were also tested in regard to neurological deficit measured with use of the National Health Institute Stroke Scale (NIHSS) and Glasgow Coma Scale (GCS) on admission, in 1, 24 and 72 hours as well as 15 and 90 days after the ICH onset. Modified Rankin Scale (mRS) was used for assessment on day 15 and 90 after ICH. Results: The total of 384 ICH patients were included in the analysis. 3 months case fatality was 20%(n=72). Following biomarkers correlated with 90-day mortality: Serum glucose level (8,1mg% vs 7,2 mg%, p<0,001, 95%CI 0,221-0,488), GFAP (4,7ug/l vs 0,3ug/l, p<0,001, 95%CI 0,255- 0,567) and IL-6 (11,9ng/l vs 6,6ng/l, p=0,001, 95%CI 0,087-0,389) were significantly higher in ICH patients who died within 3 months after stroke onset than in survivors. All these biomarkers correlat-ed significantly with the neurologic deficit measured on admission, in 1,24 and 72 hours as well as 15 and 90 days from ICH onset. Conclusion: There is a clear relation of the baseline serum glucose, GFAP and IL-6 levels to neuro-logic deficit and 90-day mortality. The findings add to the meaning of the biomarkers in ICH course and prognosis and provide another argument in terms of therapeutic targets.
Karger_ESC London_2013
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