Association Between High‐Density Lipoprotein‐to‐Low‐Density Lipoprotein Ratio and Clinical Outcomes in Intracerebral Hemorrhage: Results From a Multicenter Prospective Registry

Background Although the clinical significance of lipidemic profiles has been reported in ischemic stroke, fewer studies reported the clinical significance of these lipidemic profiles in intracerebral hemorrhage. This study aimed to investigate the relationship between high‐density lipoprotein to low‐density lipoprotein ratios and long‐term clinical outcomes including functional dependence and mortality. Methods Based on a multicenter, real‐world registry, our study included patients with intracerebral hemorrhage hospitalized within 72 hours from symptoms onset. Divided into quartiles (Q1–Q4), the association between high‐density lipoprotein to low‐density lipoprotein ratios and poor functional outcomes (modified Rankin Scale scores 3–6) was investigated using multivariable logistic regression models. Results The final study included 869 intracerebral hemorrhage patients, with a median National Institutes of Health Stroke Scale score of 9 (3–16) and median hematoma volume of 13.4 mL (5.7–31). In the fully adjusted logistic model, where the high‐density lipoprotein to low‐density lipoprotein ratio was analyzed as a continuous variable, a higher ratio was significantly associated with an elevated odds of poor functional outcome at 90 days (adjusted odds ratio (OR), 4.57 [95% CI 1.70–12.29], P =0.003) and at 1 year (adjusted OR, 2.93 [95% CI 1.08–7.99], P =0.036). The sensitivity analyses confirmed that, compared with high‐density lipoprotein or low‐density lipoprotein separately, the high‐density lipoprotein to low‐density lipoprotein ratios emerged as a more robust and consistent predictor in patients with intracerebral hemorrhage without receiving surgical intervention. Conclusions Our study delineated the association between high‐density lipoprotein to low‐density lipoprotein ratios and poor functional outcomes in patients with intracerebral hemorrhage.