Very low LDL cholesterol levels may increase the risk of bleeding in patients with stroke who are receiving dual antiplatelet therapy.
Investigators analyzed pooled data from two randomized, double-blind, placebo-controlled clinical trials in China of patients with MIS or HRTIA who were receiving DAPT.At 3 months after stroke, a total of 270 bleeding events were reported, of which 5.16% occurred in those with LDL < 70 mg/dL and 3.46% in patients with LDL ≥ 70 mg/dL.
An LDL level of < 70 mg/dL was associated with an increased risk of any bleeding (adjusted hazard ratio , 1.48;In particular, the risk of any bleeding was increased at lower LDL cholesterol levels in the ticagrelor-aspirin group (aHR, 1.71;"Weighing the risks and benefits is crucial when simultaneously considering the selection of LDL-C target strategies and DAPT regimens among these patients," the authors wrote.
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