title: LDL-C/HDL-C ratio and risk of all-cause mortality in patients with intracerebral hemorrhage.
abstract: BACKGROUND
  The low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio has been recognized as a strong risk predictor of cardiovascular diseases. However, the association between the LDL-C/HDL-C ratio and the prognosis of acute intracranial hemorrhage (ICH) is unclear. Thus, we prospectively investigated whether a low LDL-C/HDL-C ratio could predict all-cause mortality and whether LDL-C/HDL-C ratio is superior to traditional lipid profiles in predicting mortality among Chinese patients with acute ICH.
  
  
  METHODS
  A prospective cohort study of 356 patients with acute ICH was conducted, and the mean follow-up time point was 80.4 days. Participants were divided into four categories based on LDL-C/HDL-C ratio quartiles. Three-month outcomes were evaluated by in-person or telephone interviews with patients or their family members. The end point was three-month mortality from all causes.
  
  
  RESULTS
  Forty-seven deaths from all causes were documented. The multivariate analysis found that LDL-C/HDL-C ratio [hazard ratio (HR) = 0.49, p = 0.008] and LDL-C (HR = 0.27, p = 0.044) were significantly associated with all-cause mortality. The Kaplan-Meier curves show that patients in the lowest quartiles had the highest cumulative incidence rates (log-rank p = 0.027). After adjusting for covariates, a low LDL-C/HDL-C ratio was associated with a 3.55-fold increase in the risk of all-cause mortality (HR, 3.55 [95% confidence interval, 1.04-12.14]; P-trend = 0.011) when the highest and lowest quartiles were compared. The C-statistic of the LDL-C/HDL-C ratio was significantly larger than other traditional lipid profiles (all p < 0.05).
  
  
  CONCLUSIONS
  A low LDL-C/HDL-C ratio was independently associated with an increased risk of all-cause mortality at three months in patients with ICH. Moreover, the LDL-C/HDL-C ratio appeared to be a best lipid predictor of all-cause mortality than traditional lipid profiles.
authors.affiliation: a Department of Neurology , The Second Affiliated Hospital of Soochow University , Suzhou , China.
authors.forename: Shoujiang
authors.initials: S
authors.lastname: You
authors.affiliation: b Department of Epidemiology , School of Public Health, Medical College of Soochow University , Suzhou , China.
authors.forename: Chongke
authors.initials: C
authors.lastname: Zhong
authors.affiliation: a Department of Neurology , The Second Affiliated Hospital of Soochow University , Suzhou , China.
authors.forename: Jiaping
authors.initials: J
authors.lastname: Xu
authors.affiliation: c Department of Neurology , The hospital of traditional Chinese medicine , Suzhou , China.
authors.forename: Qiao
authors.initials: Q
authors.lastname: Han
authors.affiliation: a Department of Neurology , The Second Affiliated Hospital of Soochow University , Suzhou , China.
authors.forename: Xia
authors.initials: X
authors.lastname: Zhang
authors.affiliation: a Department of Neurology , The Second Affiliated Hospital of Soochow University , Suzhou , China.
authors.forename: Huihui
authors.initials: H
authors.lastname: Liu
authors.affiliation: a Department of Neurology , The Second Affiliated Hospital of Soochow University , Suzhou , China.
authors.forename: Yanlin
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: a Department of Neurology , The Second Affiliated Hospital of Soochow University , Suzhou , China.
authors.forename: Jijun
authors.initials: J
authors.lastname: Shi
authors.affiliation: a Department of Neurology , The Second Affiliated Hospital of Soochow University , Suzhou , China.
authors.forename: Zhichao
authors.initials: Z
authors.lastname: Huang
authors.affiliation: a Department of Neurology , The Second Affiliated Hospital of Soochow University , Suzhou , China.
authors.forename: Guodong
authors.initials: G
authors.lastname: Xiao
authors.affiliation: a Department of Neurology , The Second Affiliated Hospital of Soochow University , Suzhou , China.
authors.forename: Chunyuan
authors.initials: C
authors.lastname: Zhang
authors.affiliation: a Department of Neurology , The Second Affiliated Hospital of Soochow University , Suzhou , China.|d Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psycho-Diseases & Institute of Neuroscience , Soochow University , Suzhou , China.
authors.forename: Yongjun
authors.initials: Y
authors.lastname: Cao
authors.affiliation: a Department of Neurology , The Second Affiliated Hospital of Soochow University , Suzhou , China.|d Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psycho-Diseases & Institute of Neuroscience , Soochow University , Suzhou , China.
authors.forename: Chunfeng
authors.initials: C
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000401:mortality*; D008076:Cholesterol, HDL / Q000378:metabolism*; D008078:Cholesterol, LDL / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D015898:Tomography Scanners, X-Ray Computed; D055815:Young Adult
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL
keywords: Intracranial hemorrhage; Low-density lipoprotein cholesterol; Low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio; Mortality