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Dyslipidemia and Hemorrhagic Stroke

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Stroke Revisited: Dyslipidemia in Stroke

Part of the book series: Stroke Revisited ((STROREV))

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Abstract

Dyslipidemia is not as strong a risk factor as hypertension for hemorrhagic stroke. Moreover, studies have reported opposite or neutral results regarding the association between dyslipidemia and intracerebral hemorrhage (ICH) according to patient age, race, and research years. A meta-analysis of well-designed studies concluded that the risk of hemorrhagic stroke is inversely related to serum levels of total cholesterol and low-density lipoprotein cholesterol. However, the risk of hemorrhagic stroke was not associated with the serum triglyceride and high-density lipoprotein cholesterol levels. Statin or lipid-lowering therapy has routinely been used the past two decades to avoid cardiovascular events. However, concern is increasing about the risk of ICH following lipid-lowering therapy. In meta-analyses, there was no association between statin or lipid-lowering therapy and the risk of ICH in primary stroke prevention. In secondary stroke prevention, the risk of ICH showed a nonsignificant trend for statin therapy and was significantly associated with lipid-lowering therapy. The risk of ICH from statin or lipid-lowering therapy is offset by the prevention of ischemic stroke and substantial and significant improvement in mortality and functional outcomes. Therefore, clinicians should not stop statin or lipid-lowering therapies to prevent cardiovascular events.

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References

  1. Yano K, Reed DM, MacLean CJ. Serum cholesterol and hemorrhagic stroke in the Honolulu heart program. Stroke. 1989;20(11):1460–5.

    Article  CAS  PubMed  Google Scholar 

  2. Tanaka H, Ueda Y, Hayashi M, Date C, Baba T, Yamashita H, et al. Risk factors for cerebral hemorrhage and cerebral infarction in a Japanese rural community. Stroke. 1982;13(1):62–73.

    Article  CAS  PubMed  Google Scholar 

  3. Iso H, Jacobs DR Jr, Wentworth D, Neaton JD, Cohen JD. Serum cholesterol levels and six-year mortality from stroke in 350,977 men screened for the multiple risk factor intervention trial. N Engl J Med. 1989;320(14):904–10.

    Article  CAS  PubMed  Google Scholar 

  4. Wang X, Dong Y, Qi X, Huang C, Hou L. Cholesterol levels and risk of hemorrhagic stroke: a systematic review and meta-analysis. Stroke. 2013;44(7):1833–9.

    Article  CAS  PubMed  Google Scholar 

  5. Knekt P, Reunanen A, Aho K, Heliovaara M, Rissanen A, Aromaa A, et al. Risk factors for subarachnoid hemorrhage in a longitudinal population study. J Clin Epidemiol. 1991;44(9):933–9.

    Article  CAS  PubMed  Google Scholar 

  6. Gatchev O, Rastam L, Lindberg G, Gullberg B, Eklund GA, Isacsson SO. Subarachnoid hemorrhage, cerebral hemorrhage, and serum cholesterol concentration in men and women. Ann Epidemiol. 1993;3(4):403–9.

    Article  CAS  PubMed  Google Scholar 

  7. Iribarren C, Jacobs DR, Sadler M, Claxton AJ, Sidney S. Low total serum cholesterol and intracerebral hemorrhagic stroke: is the association confined to elderly men? The Kaiser Permanente medical care program. Stroke. 1996;27(11):1993–8.

    Article  CAS  PubMed  Google Scholar 

  8. Leppala JM, Virtamo J, Fogelholm R, Albanes D, Heinonen OP. Different risk factors for different stroke subtypes: association of blood pressure, cholesterol, and antioxidants. Stroke. 1999;30(12):2535–40.

    Article  CAS  PubMed  Google Scholar 

  9. Okumura K, Iseki K, Wakugami K, Kimura Y, Muratani H, Ikemiya Y, et al. Low serum cholesterol as a risk factor for hemorrhagic stroke in men: a community-based mass screening in Okinawa, Japan. Jpn Circ J. 1999;63(1):53–8.

    Article  CAS  PubMed  Google Scholar 

  10. Hart CL, Hole DJ, Smith GD. The relation between cholesterol and haemorrhagic or ischaemic stroke in the Renfrew/Paisley study. J Epidemiol Community Health. 2000;54(11):874–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Suh I, Jee SH, Kim HC, Nam CM, Kim IS, Appel LJ. Low serum cholesterol and haemorrhagic stroke in men: Korea medical insurance corporation study. Lancet. 2001;357(9260):922–5.

    Article  CAS  PubMed  Google Scholar 

  12. Engstrom G, Lind P, Hedblad B, Stavenow L, Janzon L, Lindgarde F. Effects of cholesterol and inflammation-sensitive plasma proteins on incidence of myocardial infarction and stroke in men. Circulation. 2002;105(22):2632–7.

    Article  CAS  PubMed  Google Scholar 

  13. Jood K, Jern C, Wilhelmsen L, Rosengren A. Body mass index in mid-life is associated with a first stroke in men: a prospective population study over 28 years. Stroke. 2004;35(12):2764–9.

    Article  PubMed  Google Scholar 

  14. Zhang XF, Attia J, D'Este C, Yu XH. Prevalence and magnitude of classical risk factors for stroke in a cohort of 5092 Chinese steelworkers over 13.5 years of follow-up. Stroke. 2004;35(5):1052–6.

    Article  PubMed  Google Scholar 

  15. Ebrahim S, Sung J, Song YM, Ferrer RL, Lawlor DA, Davey SG. Serum cholesterol, haemorrhagic stroke, ischaemic stroke, and myocardial infarction: Korean national health system prospective cohort study. BMJ. 2006;333(7557):22.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Sturgeon JD, Folsom AR, Longstreth W Jr, Shahar E, Rosamond WD, Cushman M. Risk factors for intracerebral hemorrhage in a pooled prospective study. Stroke. 2007;38(10):2718–25.

    Article  PubMed  Google Scholar 

  17. Noda H, Iso H, Irie F, Sairenchi T, Ohtaka E, Doi M, et al. Low-density lipoprotein cholesterol concentrations and death due to intraparenchymal hemorrhage: the Ibaraki prefectural health study. Circulation. 2009;119(16):2136–45.

    Article  CAS  PubMed  Google Scholar 

  18. Nago N, Ishikawa S, Goto T, Kayaba K. Low cholesterol is associated with mortality from stroke, heart disease, and cancer: the Jichi medical school cohort study. J Epidemiol. 2011;21(1):67–74.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Zhang Y, Tuomilehto J, Jousilahti P, Wang Y, Antikainen R, Hu G. Total and high-density lipoprotein cholesterol and stroke risk. Stroke. 2012;43(7):1768–74.

    Article  PubMed  CAS  Google Scholar 

  20. Bots ML, Elwood PC, Nikitin Y, Salonen JT, Freire de Concalves A, Inzitari D, et al. Total and HDL cholesterol and risk of stroke. EUROSTROKE: a collaborative study among research centres in Europe. J Epidemiol Community Health. 2002;56(Suppl 1):i19–24.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Cui R, Iso H, Toyoshima H, Date C, Yamamoto A, Kikuchi S, et al. Serum total cholesterol levels and risk of mortality from stroke and coronary heart disease in Japanese: the JACC study. Atherosclerosis. 2007;194(2):415–20.

    Article  CAS  PubMed  Google Scholar 

  22. Jin X, Chen H, Shi H, Fu K, Li J, Tian L, et al. Lipid levels and the risk of hemorrhagic stroke: a dose-response meta-analysis. Nutr Metab Cardiovasc Dis. 2021;31(1):23–35.

    Article  CAS  PubMed  Google Scholar 

  23. Iribarren C, Reed DM, Burchfiel CM, Dwyer JH. Serum total cholesterol and mortality. Confounding factors and risk modification in Japanese-American men. JAMA. 1995;273(24):1926–32.

    Article  CAS  PubMed  Google Scholar 

  24. Korja M, Silventoinen K, Laatikainen T, Jousilahti P, Salomaa V, Hernesniemi J, et al. Risk factors and their combined effects on the incidence rate of subarachnoid hemorrhage--a population-based cohort study. PLoS One. 2013;8(9):e73760.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Liu X, Yan L, Xue F. The associations of lipids and lipid ratios with stroke: a prospective cohort study. J Clin Hypertens (Greenwich). 2019;21(1):127–35.

    Article  CAS  Google Scholar 

  26. Ma C, Gurol ME, Huang Z, Lichtenstein AH, Wang X, Wang Y, et al. Low-density lipoprotein cholesterol and risk of intracerebral hemorrhage: a prospective study. Neurology. 2019;93(5):e445–e57.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Rist PM, Buring JE, Ridker PM, Kase CS, Kurth T, Rexrode KM. Lipid levels and the risk of hemorrhagic stroke among women. Neurology. 2019;92(19):e2286–e94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Yi SW, Shin DH, Kim H, Yi JJ, Ohrr H. Total cholesterol and stroke mortality in middle-aged and elderly adults: a prospective cohort study. Atherosclerosis. 2018;270:211–7.

    Article  CAS  PubMed  Google Scholar 

  29. Zhang Q, Zhou Y, Gao X, Wang C, Zhang S, Wang A, et al. Ideal cardiovascular health metrics and the risks of ischemic and intracerebral hemorrhagic stroke. Stroke. 2013;44(9):2451–6.

    Article  PubMed  Google Scholar 

  30. Zheng J, Sun Z, Zhang X, Li Z, Guo X, Xie Y, et al. Non-traditional lipid profiles associated with ischemic stroke not hemorrhagic stroke in hypertensive patients: results from an 8.4 years follow-up study. Lipids Health Dis. 2019;18(1):9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Inagawa T, Ohbayashi N, Takechi A, Shibukawa M, Yahara K. Primary intracerebral hemorrhage in Izumo City, Japan: incidence rates and outcome in relation to the site of hemorrhage. Neurosurgery. 2003;53(6):1283–97. Discussion 97-8

    Article  PubMed  Google Scholar 

  32. Jolink WMT, Wiegertjes K, Rinkel GJE, Algra A, de Leeuw FE, Klijn CJM. Location-specific risk factors for intracerebral hemorrhage: systematic review and meta-analysis. Neurology. 2020;95(13):e1807–e18.

    Article  CAS  PubMed  Google Scholar 

  33. Lindbohm JV, Kaprio J, Korja M. Cholesterol as a risk factor for subarachnoid hemorrhage: a systematic review. PLoS One. 2016;11(4):e0152568.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  34. Can A, Castro VM, Dligach D, Finan S, Yu S, Gainer V, et al. Lipid-lowering agents and high HDL (high-density lipoprotein) are inversely associated with intracranial aneurysm rupture. Stroke. 2018;49(5):1148–54.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Ma C, Na M, Neumann S, Gao X. Low-density lipoprotein cholesterol and risk of hemorrhagic stroke: a systematic review and dose-response meta-analysis of prospective studies. Curr Atheroscler Rep. 2019;21(12):52.

    Article  CAS  PubMed  Google Scholar 

  36. Glasser SP, Mosher A, Howard G, Banach M. What is the association of lipid levels and incident stroke? Int J Cardiol. 2016;220:890–4.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Holme I, Aastveit AH, Hammar N, Jungner I, Walldius G. Relationships between lipoprotein components and risk of ischaemic and haemorrhagic stroke in the apolipoprotein MOrtality RISk study (AMORIS). J Intern Med. 2009;265(2):275–87.

    Article  CAS  PubMed  Google Scholar 

  38. Imamura T, Doi Y, Arima H, Yonemoto K, Hata J, Kubo M, et al. LDL cholesterol and the development of stroke subtypes and coronary heart disease in a general Japanese population: the Hisayama study. Stroke. 2009;40(2):382–8.

    Article  CAS  PubMed  Google Scholar 

  39. Psaty BM, Anderson M, Kronmal RA, Tracy RP, Orchard T, Fried LP, et al. The association between lipid levels and the risks of incident myocardial infarction, stroke, and total mortality: the cardiovascular health study. J Am Geriatr Soc. 2004;52(10):1639–47.

    Article  PubMed  Google Scholar 

  40. Stoekenbroek RM, Boekholdt SM, Luben R, Hovingh GK, Zwinderman AH, Wareham NJ, et al. Heterogeneous impact of classic atherosclerotic risk factors on different arterial territories: the EPIC-Norfolk prospective population study. Eur Heart J. 2016;37(11):880–9.

    Article  PubMed  Google Scholar 

  41. Sun L, Clarke R, Bennett D, Guo Y, Walters RG, Hill M, et al. Causal associations of blood lipids with risk of ischemic stroke and intracerebral hemorrhage in Chinese adults. Nat Med. 2019;25(4):569–74.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Wieberdink RG, Poels MM, Vernooij MW, Koudstaal PJ, Hofman A, van der Lugt A, et al. Serum lipid levels and the risk of intracerebral hemorrhage: the Rotterdam study. Arterioscler Thromb Vasc Biol. 2011;31(12):2982–9.

    Article  CAS  PubMed  Google Scholar 

  43. Zhang X, Liu J, Wang M, Qi Y, Sun J, Liu J, et al. Twenty-year epidemiologic study on LDL-C levels in relation to the risks of atherosclerotic event, hemorrhagic stroke, and cancer death among young and middle-aged population in China. J Clin Lipidol. 2018;12(5):1179–89 e4.

    Article  PubMed  Google Scholar 

  44. Chang JJ, Katsanos AH, Khorchid Y, Dillard K, Kerro A, Burgess LG, et al. Higher low-density lipoprotein cholesterol levels are associated with decreased mortality in patients with intracerebral hemorrhage. Atherosclerosis. 2018;269:14–20.

    Article  CAS  PubMed  Google Scholar 

  45. Bonaventure A, Kurth T, Pico F, Barberger-Gateau P, Ritchie K, Stapf C, et al. Triglycerides and risk of hemorrhagic stroke vs. ischemic vascular events: the Three-City study. Atherosclerosis. 2010;210(1):243–8.

    Article  CAS  PubMed  Google Scholar 

  46. Saito I, Yamagishi K, Kokubo Y, Yatsuya H, Iso H, Sawada N, et al. Association of high-density lipoprotein cholesterol concentration with different types of stroke and coronary heart disease: the Japan public health center-based prospective (JPHC) study. Atherosclerosis. 2017;265:147–54.

    Article  CAS  PubMed  Google Scholar 

  47. Watanabe J, Kakehi E, Kotani K, Kayaba K, Nakamura Y, Ishikawa S. High-density lipoprotein cholesterol and risk of stroke subtypes: Jichi medical school cohort study. Asia Pac J Public Health. 2020;32(1):27–34.

    Article  PubMed  Google Scholar 

  48. Harayama T, Riezman H. Understanding the diversity of membrane lipid composition. Nat Rev Mol Cell Biol. 2018;19(5):281–96.

    Article  CAS  PubMed  Google Scholar 

  49. Yamori Y, Nara Y, Horie R, Ooshima A. Abnormal membrane characteristics of erythrocytes in rat models and men with predisposition to stroke. Clin Exp Hypertens. 1980;2(6):1009–21.

    Article  CAS  PubMed  Google Scholar 

  50. Konishi M, Iso H, Komachi Y, Iida M, Shimamoto T, Jacobs DR Jr, et al. Associations of serum total cholesterol, different types of stroke, and stenosis distribution of cerebral arteries. Akita Pathol Stud Stroke. 1993;24(7):954–64.

    Article  CAS  Google Scholar 

  51. Rosenson RS, Lowe GD. Effects of lipids and lipoproteins on thrombosis and rheology. Atherosclerosis. 1998;140(2):271–80.

    Article  CAS  PubMed  Google Scholar 

  52. Chadarevian R, Bruckert E, Dejager S, Presberg P, Turpin G. Relationship between triglycerides and factor VIIc and plasminogen activator inhibitor type-1: lack of threshold value. Thromb Res. 1999;96(3):175–82.

    Article  CAS  PubMed  Google Scholar 

  53. Griffin JH, Fernandez JA, Deguchi H. Plasma lipoproteins, hemostasis and thrombosis. Thromb Haemost. 2001;86(1):386–94.

    CAS  PubMed  Google Scholar 

  54. Wang N, Fulcher J, Abeysuriya N, Park L, Kumar S, Di Tanna GL, et al. Intensive LDL cholesterol-lowering treatment beyond current recommendations for the prevention of major vascular events: a systematic review and meta-analysis of randomised trials including 327 037 participants. Lancet Diabetes Endocrinol. 2020;8(1):36–49.

    Article  PubMed  Google Scholar 

  55. Amarenco P, Bogousslavsky J, Callahan A 3rd, Goldstein LB, Hennerici M, Rudolph AE, et al. High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med. 2006;355(6):549–59.

    Article  CAS  PubMed  Google Scholar 

  56. Goldstein LB, Amarenco P, Szarek M, Callahan A 3rd, Hennerici M, Sillesen H, et al. Hemorrhagic stroke in the stroke prevention by aggressive reduction in Cholesterol levels study. Neurology. 2008;70(24 Pt 2):2364–70.

    Article  CAS  PubMed  Google Scholar 

  57. Collins R, Armitage J, Parish S, Sleight P, Peto R. Heart protection study collaborative G. effects of cholesterol-lowering with simvastatin on stroke and other major vascular events in 20536 people with cerebrovascular disease or other high-risk conditions. Lancet. 2004;363(9411):757–67.

    Article  PubMed  CAS  Google Scholar 

  58. Manktelow BN, Potter JF. Interventions in the management of serum lipids for preventing stroke recurrence. Cochrane Database Syst Rev. 2009;3:CD002091.

    Google Scholar 

  59. Cholesterol Treatment Trialists C, Mihaylova B, Emberson J, Blackwell L, Keech A, Simes J, et al. The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. Lancet. 2012;380(9841):581–90.

    Article  CAS  Google Scholar 

  60. Ziff OJ, Banerjee G, Ambler G, Werring DJ. Statins and the risk of intracerebral haemorrhage in patients with stroke: systematic review and meta-analysis. J Neurol Neurosurg Psychiatry. 2019;90(1):75–83.

    Article  PubMed  Google Scholar 

  61. Blanco M, Nombela F, Castellanos M, Rodriguez-Yanez M, Garcia-Gil M, Leira R, et al. Statin treatment withdrawal in ischemic stroke: a controlled randomized study. Neurology. 2007;69(9):904–10.

    Article  CAS  PubMed  Google Scholar 

  62. Hackam DG, Austin PC, Huang A, Juurlink DN, Mamdani MM, Paterson JM, et al. Statins and intracerebral hemorrhage: a retrospective cohort study. Arch Neurol. 2012;69(1):39–45.

    Article  PubMed  Google Scholar 

  63. Chang CH, Lin CH, Caffrey JL, Lee YC, Liu YC, Lin JW, et al. Risk of intracranial hemorrhage from statin use in Asians: a nationwide cohort study. Circulation. 2015;131(23):2070–8.

    Article  CAS  PubMed  Google Scholar 

  64. Lee M, Saver JL, Wu YL, Tang SC, Lee JD, Rao NM, et al. Utilization of statins beyond the initial period after stroke and 1-year risk of recurrent stroke. J Am Heart Assoc. 2017;6(8):e005658.

    PubMed  PubMed Central  Google Scholar 

  65. Ribe AR, Vestergaard CH, Vestergaard M, Pedersen HS, Prior A, Lietzen LW, et al. Statins and risk of intracerebral hemorrhage in individuals with a history of stroke. Stroke. 2020;51(4):1111–9.

    Article  PubMed  Google Scholar 

  66. Amarenco P, Kim JS, Labreuche J, Charles H, Abtan J, Bejot Y, et al. A comparison of two LDL cholesterol targets after ischemic stroke. N Engl J Med. 2020;382(1):9.

    Article  CAS  PubMed  Google Scholar 

  67. Mach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badimon L, et al. 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020;41(1):111–88.

    Article  PubMed  Google Scholar 

  68. Haussen DC, Henninger N, Kumar S, Selim M. Statin use and microbleeds in patients with spontaneous intracerebral hemorrhage. Stroke. 2012;43(10):2677–81.

    Article  CAS  PubMed  Google Scholar 

  69. Woo D, Deka R, Falcone GJ, Flaherty ML, Haverbusch M, Martini SR, et al. Apolipoprotein E, statins, and risk of intracerebral hemorrhage. Stroke. 2013;44(11):3013–7.

    Article  CAS  PubMed  Google Scholar 

  70. Jung JM, Choi JY, Kim HJ, Seo WK. Statin use in spontaneous intracerebral hemorrhage: a systematic review and meta-analysis. Int J Stroke. 2015;10(Suppl A100):10–7.

    Article  PubMed  Google Scholar 

  71. Chen C-J, Ding D, Ironside N, Buell TJ, Elder LJ, Warren A, et al. Statins for neuroprotection in spontaneous intracerebral hemorrhage. Neurology. 2019;93(24):1056–66.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Yang D, Knight RA, Han Y, Karki K, Zhang J, Ding C, et al. Vascular recovery promoted by atorvastatin and simvastatin after experimental intracerebral hemorrhage: magnetic resonance imaging and histological study. J Neurosurg. 2011;114(4):1135–42.

    Article  PubMed  Google Scholar 

  73. Cui JJ, Wang D, Gao F, Li YR. Effects of atorvastatin on pathological changes in brain tissue and plasma MMP-9 in rats with intracerebral hemorrhage. Cell Biochem Biophys. 2012;62(1):87–90.

    Article  CAS  PubMed  Google Scholar 

  74. Ewen T, Qiuting L, Chaogang T, Tao T, Jun W, Liming T, et al. Neuroprotective effect of atorvastatin involves suppression of TNF-alpha and upregulation of IL-10 in a rat model of intracerebral hemorrhage. Cell Biochem Biophys. 2013;66(2):337–46.

    Article  PubMed  CAS  Google Scholar 

  75. Chen Q, Shi X, Tan Q, Feng Z, Wang Y, Yuan Q, et al. Simvastatin promotes hematoma absorption and reduces hydrocephalus following intraventricular hemorrhage in part by upregulating CD36. Transl Stroke Res. 2017;8(4):362–73.

    Article  CAS  PubMed  Google Scholar 

  76. Wang Y, Chen Q, Tan Q, Feng Z, He Z, Tang J, et al. Simvastatin accelerates hematoma resolution after intracerebral hemorrhage in a PPARgamma-dependent manner. Neuropharmacology. 2018;128:244–54.

    Article  CAS  PubMed  Google Scholar 

  77. Flint AC, Conell C, Rao VA, Klingman JG, Sidney S, Johnston SC, et al. Effect of statin use during hospitalization for intracerebral hemorrhage on mortality and discharge disposition. JAMA Neurol. 2014;71(11):1364–71.

    Article  PubMed  Google Scholar 

  78. Pan YS, Jing J, Wang YL, Zhao XQ, Song B, Wang WJ, et al. Use of statin during hospitalization improves the outcome after intracerebral hemorrhage. CNS Neurosci Ther. 2014;20(6):548–55.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  79. Chen PS, Cheng CL, Chang YC, Kao Yang YH, Yeh PS, Li YH. Early statin therapy in patients with acute intracerebral hemorrhage without prior statin use. Eur J Neurol. 2015;22(5):773–80.

    Article  PubMed  Google Scholar 

  80. Gertz K, Laufs U, Lindauer U, Nickenig G, Bohm M, Dirnagl U, et al. Withdrawal of statin treatment abrogates stroke protection in mice. Stroke. 2003;34(2):551–7.

    Article  CAS  PubMed  Google Scholar 

  81. Endres M, Laufs U. Discontinuation of statin treatment in stroke patients. Stroke. 2006;37(10):2640–3.

    Article  CAS  PubMed  Google Scholar 

  82. Endres M, Nolte CH, Scheitz JF. Statin treatment in patients with intracerebral hemorrhage. Stroke. 2018;49(1):240–6.

    Article  PubMed  Google Scholar 

  83. Dowlatshahi D, Demchuk AM, Fang J, Kapral MK, Sharma M, Smith EE, et al. Association of statins and statin discontinuation with poor outcome and survival after intracerebral hemorrhage. Stroke. 2012;43(6):1518–23.

    Article  CAS  PubMed  Google Scholar 

  84. Asberg S, Farahmand B, Henriksson KM, Appelros P. Statins as secondary preventives in patients with intracerebral hemorrhage. Int J Stroke. 2020;15(1):61–8.

    Article  PubMed  Google Scholar 

  85. Judge C, Ruttledge S, Costello M, Murphy R, Loughlin E, Alvarez-Iglesias A, et al. Lipid lowering therapy, low-density lipoprotein level and risk of intracerebral hemorrhage - a meta-analysis. J Stroke Cerebrovasc Dis. 2019;28(6):1703–9.

    Article  PubMed  Google Scholar 

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  1. Department of Neurology, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Republic of Korea

    Sung-Il Sohn

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  1. Department of Neurology, Seoul National University Hospital, Seoul, Korea (Republic of)

    Seung-Hoon Lee

  2. Department of Neurology, Uijeongbu Eulji Medical Center, Gyeonggi, Korea (Republic of)

    Min Kyoung Kang

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Sohn, SI. (2021). Dyslipidemia and Hemorrhagic Stroke. In: Lee, SH., Kang, M.K. (eds) Stroke Revisited: Dyslipidemia in Stroke. Stroke Revisited. Springer, Singapore. https://doi.org/10.1007/978-981-16-3923-4_4

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