IMR Press / JIN / Volume 23 / Issue 4 / DOI: 10.31083/j.jin2304076
Open Access Original Research
Association between Lipid-Lowering Drugs and Traumatic Subdural Hemorrhage: A Mendelian Randomization Study
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1 Department of Neurosurgery, Xiang’an Hospital of Xiamen University, 361100 Xiamen, Fujian, China
2 Department of Ultrasound, Maternal and Child Health Hospital of Fujian Province, 350005 Fuzhou, Fujian, China
3 Department of Hepatobiliary Surgery, The Affiliated Longyan First Hospital of Fujian Medical University, 361000 Longyan, Fujian, China
4 Department of Otolaryngology-Head and Neck Surgery, Xiang’an Hospital of Xiamen University, 361100 Xiamen, Fujian, China
5 Department of Neurosurgery, Fuzong Clinical Medical College of Fujian Medical University (The 900th Hospital of Joint Logistic Team of PLA), 350025 Fuzhou, Fujian, China
*Correspondence: wlf74@163.com (Liangfeng Wei)
J. Integr. Neurosci. 2024, 23(4), 76; https://doi.org/10.31083/j.jin2304076
Submitted: 30 June 2023 | Revised: 20 September 2023 | Accepted: 7 October 2023 | Published: 10 April 2024
Copyright: © 2024 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: There are current clinical observations that atorvastatin may promote subdural hematoma resorption. We aimed to assess the causal effects of lipid-lowering agents 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR) inhibitors, Proproteinconvertase subtilisin/kexin type 9 (PCSK9) inhibitors and Niemann-Pick C1-like protein 1 (NPC1L1) inhibitors on traumatic subdural hematomas. Methods: We used genetic instruments to proxy lipid-lowering drug exposure, with genetic instruments being genetic variants within or near low-density lipoprotein (LDL cholesterol)-associated drug target genes. These were analyzed by using a two-sample Mendelian randomization (MR) study. Results: A causal relationship was found between HMGCR inhibitors and traumatic subdural hematoma (Inverse variance weighted (β = –0.7593341 (Odds Ratio (OR) = 0.4679779), p = 0.008366947 < 0.05)). However, no causal relationship was found between PCSK9 inhibitors and NPC1L1 inhibitors and traumatic subdural hematoma (PCSK9 inhibitors: Inverse variance weighted (β = 0.23897796 (OR = 1.2699505), p = 0.1126327), NPC1L1 inhibitors: Inverse variance weighted (β = –0.02118558 (OR = 0.9790373), p = 0.9701686)). Sensitivity analysis of the data revealed good stability of the results. Conclusions: This two-sample MR study suggests a potential causal relationship between HMGCR inhibition (atorvastatin) and traumatic subdural hemorrhage.

Keywords
lipid-lowering drugs
traumatic subdural hemorrhage
mendelian randomization analysis
cause-and-effect relationship
drug targeting
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