Introduction:An inverse association between serum cholesterol and the risk of hemorrhagic stroke has been noted in epidemiological studies. We performed a case–control study to assess the relationship between primary intracerebral hemorrhage (ICH) and low serum cholesterol.Materials and Methods:Prospectively recruited fully evaluated patients with ICH were compared with a control group based in a primary care practice, i.e. age- and sex-matched individuals attending the routine preventive health check-up. Low cholesterol was defined by the sex-specific lowest quintile of the population.Results:The proportion of ICH patients with low cholesterol was significantly higher than the controls (68% vs. 43%). Mean total cholesterol was also signficantly low in ICH patients compared with controls (177 mg/dL vs. 200 mg/dl; P-value = 0.0006). Low-density lipoprotein cholesterol (LDL-c) and triglycerides were also significantly low in ICH patients compared with controls. Mean LDL-C in the ICH patient group was 114 mg/dL, whereas it was 128.5 mg/dL in the control group (P-value = 0.016). There was no significant difference in the high-density lipoprotein (HDL) levels in both groups. In a subgroup analysis, both men and women in the ICH group had a significantly low mean cholesterol compared with the control group. Although lower mean cholesterol was seen in both young and older individuals in the ICH group than in controls, the difference was significant only in the older group (age >45 years). In multivariate analysis, presence of low cholesterol remained a significant predictor of hemorrhage. The odds ratio of low cholesterol in the hemorrhage cases was 2.75 (95% CI = 1.44–5.49) unadjusted and 2.15 (1.13–4.70) adjusted for age and hypertension.Conclusions:This study confirms an increased risk of primary ICH associated with low cholesterol both in men and women, especially in older individuals.
Over the past decade, there has been a progressive evolution of cardiac marker testing in patients with acute coronary syndromes. Myocardial infarction (MI) is the leading cause of death in the developed world. Biomarkers have an vital role in analysis, risk stratification, administrative running and medical assessment making in the setting of patients presenting with signs and symptoms of MI. Cardiac troponin (cTn) rose to prominence during the 1990s and has evolved to be the cornerstone for diagnosis of MI. Cardiac troponins are released from myocytes following myocardial damage and loss of membrane integrity. Troponin T are member of a group of cardiac regulatory proteins which function to regulate the calcium mediated interaction of muscle filaments actin and myosin resulting in contraction and relaxation of striated muscle. New algorithms integrating Brain natriuretic peptide (BNP), NT-proBNP, and more sensitive cTn assays footing potential for more rapid diagnosis of MI, allowing for appropriate management steps to be initiated and more efficient and effective utilization of healthcare resources.
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