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LDL and HDL subclasses in acute ischemic stroke: prediction of risk and short-term mortality

Aleksandra Zeljkovic1, Jelena Vekic, Vesna Spasojevic-Kalimanovska

  • 1Institute of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, and Special Hospital for Prevention and Therapy of Cerebrovascular Disease Sveti Sava, Belgrade, Serbia. aleksandra.zeljkovic@pharmacy.bg.ac.rs

Atherosclerosis
|December 22, 2009
PubMed

Insights

Small, dense low-density lipoprotein (sdLDL) particles are linked to increased risk of acute ischemic stroke (AIS). Higher sdLDL levels also predict short-term mortality after AIS, independent of other risk factors.

Area of Science:

  • Cardiovascular Research
  • Lipid Metabolism
  • Neurology

Background:

  • Small, dense low-density lipoprotein (sdLDL) and small-sized high-density lipoprotein (HDL) particles are known risk factors for ischemic heart disease.
  • The clinical significance of these lipoprotein subclasses for acute ischemic stroke (AIS) remains uncertain.

Purpose of the Study:

  • To evaluate the association of LDL and HDL particle sizes and subclasses with AIS risk.
  • To assess the relationship between lipoprotein particle characteristics and short-term mortality following AIS.

Main Methods:

  • Gradient gel electrophoresis and standard laboratory methods were used to analyze LDL and HDL particles in 200 AIS patients and 162 controls.
  • Baseline characteristics of LDL and HDL particles were assessed for their predictive value for AIS and mortality.

Main Results:

  • AIS patients exhibited increased levels of sdLDL (LDL III and IVb) and smaller HDL particles (more HDL 3a, 3b, 3c; less HDL 2b).
  • Elevated sdLDL was a significant predictor of AIS (OR=4.31) and in-hospital mortality (OR=5.50), even after adjusting for conventional risk factors.
  • sdLDL levels were significantly higher in AIS fatalities compared to survivors.

Conclusions:

  • Acute ischemic stroke (AIS) is associated with unfavorable distributions of LDL and HDL subclasses.
  • Increased sdLDL particles are independently associated with both AIS onset and subsequent short-term mortality.
Abstract

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